Is the “V” sign and the “butterfly wings” finding on MRI specific for the percheron artery infract? Four cases presented with MRI and clinical findings [MRG'de “V” işareti ve “kelebek kanatları” bulgusu percheron arter infarktına spesifik mi? MRG ve klinik bulgularıyla; dört olgu]

Paramedian thalamic arteries are separated from the p1 segment of each posterior cerebral artery. multiple variations are known to be present. one of these rare variations is called the “percheron artery” and arises from the p1 segment of the posterior cerebral artery as a single root. this artery supplies blood to bilateral paramedian thalamus and rostral mid-brain. the occlusion of the percheron artery (pa) occurs rarely,resulting in a large number of various neurologic findings and symptoms. this leads the physician to consider etiologic factors other than vascular causes. the patients are observed to have sudden and dramatic clinical signs and symptoms. thus,the manifestations need to be immediately recognized to start the appropriate treatment for the patient. during the acute period,magnetic resonance with diffusion weighted imaging is essential for diagnosis. in this report,we present 4 patients with bilateral rostral mid-brain and paramedian thalamic infarct secondary to pa occlusion,in whom we detected “butterfly wings” pattern in the mesencephalon together with a “v sign” along thepial surface of the mesencephalon by diffusion weighted imaging during the acute period. as far as we know,these imaging findings,which we believe are specific for this artery,have not been reported in the turkish literature before. we believe these findings are significant for the accurate diagnosis,timely sensitive therapy of the pa occlusion-associated infracts and in avoiding unnecessary procedures during the acute period. © 2016,ege university press. all right reserved.