We were to investigate the time course of lesions for awakening in acute Percheron artery ischemic coma (PAIC), which was previously unknown. Patients who had newly identified acute PAIC events in 2012–2015 and had not received thrombolytic therapy were enrolled retrospectively. The time course of lesions in PAIC was investigated by diffusion-weighted imaging (DWI). Ninety-three patients met the inclusion criteria, of whom 63 and 30 had transient PAIC and persistent PAIC, respectively. The time course of awakening events in persistent PAIC decreased over time, with large lesions in the bilateral paramedian thalamus/ rostral midbrain on DWI almost in all patients who was either plus or minus a “top of basilar artery” strokes. Whereas awakening events in transient PAIC increased over time, with small or lacunar lesions in the unilateral or bilateral thalamus/rostral midbrain about in 30.2 % cases, and the rest in naturally recanalization of infarcts or TIA. Lesion volumes were larger for persistent PAIC than for transient PAIC (median, 2.4 cm³ vs. 0.03 cm³, P < 0.0001). In Cox hazards ratio (HR) analysis, a lower GCS score was associated with mortality (HR, 5.5; 95 % confidence interval [CI],1.427–21.45). Multivaliate analysis shown that the predictors of higher risk of persistent PAIC were only increased NIHSS scores (HR,1.3; 95 % CI,1.109–1.640) and large lesions in bilateral thalamus/rostral midbrain (HR,15.0; 95 % CI,1.440–58.13). The time course of acute PAIC included transient and persistent. Most persistent PAIC was associated with large lesions in bilateral paramedian thalamus/ rostral midbrain, and with high mortality.

我们将研究之前未知的急性 Percheron 动脉缺血性昏迷 (PAIC) 中病灶苏醒的时间进程。回顾性招募了 2012-2015 年新发现的急性 PAIC 事件且未接受溶栓治疗的患者。通过弥散加权成像 (DWI) 研究 PAIC 病变的时间过程。93 名患者符合纳入标准，其中 63 名和 30 名分别为短暂性 PAIC 和持续性 PAIC。持续性 PAIC 中觉醒事件的时间进程随着时间的推移而减少，几乎所有伴有或减去“基底动脉顶部”卒中的患者在 DWI 上的双侧旁正中丘脑/中脑延髓中都有大的病变。而瞬态 PAIC 中的觉醒事件随着时间的推移而增加，约 30.2% 的病例在单侧或双侧丘脑/中脑嘴部有小的或腔隙性病变，其余为梗死或 TIA 的自然再通。持续性 PAIC 的病灶体积大于短暂性 PAIC（中位数，2.4 cm³对 0.03 cm ³，P < 0.0001)。在 Cox 风险比 (HR) 分析中，较低的 GCS 评分与死亡率相关（HR，5.5；95% 置信区间 [CI]，1.427–21.45）。多变量分析表明，持续性 PAIC 风险较高的预测因素仅是 NIHSS 评分增加（HR，1.3；95 % CI，1.109–1.640）和双侧丘脑/中脑延髓的大病变（HR，15.0；95 % CI，1.440– 58.13）。急性 PAIC 的时间过程包括暂时性和持续性。大多数持续性 PAIC 与双侧旁正中丘脑 / 中脑延髓的大病变有关，并且死亡率很高。