Abstract 313: Intracerebral Hemorrhage in Artery of Percheron Territory: A Rare Case of Bilateral Thalamic Hemorrhage

The artery of Percheron (AOP) is a rare anatomical variant characterized by a single arterial trunk arising from the posterior cerebral artery to supply both paramedian thalami and the rostral midbrain. While AOP occlusion typically results in bilateral thalamic infarctions with altered mental status, gaze palsy, and memory impairment, hemorrhagic events are exceedingly rare compared to ischemic strokes. This review discusses a rare case of AOP‐related bilateral thalamic hemorrhage in a 67 year‐old male with a history of cocaine use hypertension, diabetes mellitus, and chronic cerebrovascular disease. Recognizing AOP hemorrhage is critical for appropriate early management, given its rarity, atypical presentation, complex clinical course and the potential for severe neurological outcomes.