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Abstract Bilateral thalamic infarction resulting from the occlusion of the artery of Percheron (AOP) is a rare cerebrovascular event with distinctive clinical presentations. This case report explores the intricate relationship between vascular anatomy, midbrain function, and clinical manifestations. A 48‐year‐old male farmer with a history of diabetes mellitus presented with sudden‐onset visual disturbances, diplopia, bilateral eyelid drooping, and loss of consciousness. Extensive evaluations, including advanced imaging techniques, led to the diagnosis of bilateral upper midbrain infarction involving AOP. This case underscores the complexity of neurovascular interactions, highlighting the importance of precise diagnosis, and tailored management in addressing rare cerebrovascular conditions.

La afectación del sistema nervioso central en la enfermedad de Hodgkin (HDG) es excepcional. Los pacientes con lesiones malignas tienen mayor riesgo de infarto cerebral. Se presentó un paciente con antecedente de enfermedad de HDG quien presentó episodios súbitos de deterioro del nivel de conciencia y que en el período de recuperación mostró severas alteraciones en sus funciones psíquicas superiores con trastornos groseros de la memoria de fijación y evocación, desorientación témporo-espacial, acalculia, perseveraciones, conducta inadecuada y agresividad. Se determinó, mediante estudios imagenológicos, tomografía axial computarizada y resonancia magnética nuclear, el diagnóstico de infarto talámico bilateral. Se concluyó que las lesiones del tálamo que se acompañan de alteraciones de las funciones psíquicas superiores de carácter demencial son comúnmente bilaterales y que es importante diagnosticar estas complicaciones porque la mayoría son tratables. Se recomendó realizar estudios neuropsicológicos periódicos para precisar si existe recuperación evolutiva de los trastornos cognitivos y conductuales o concluir su diagnóstico como una demencia vascular talámica.The affection of the central nervous system in Hodgkin's disease is exceptional. Patients with malignant lesions are at a higher risk for stroke. A patient with history of Hodgkin's disease that had sudden episodes of deterioration of the conciousness level and that in the recovery period presented severe alterations in his higher psychical functions with gross disorders of the fixation and evocation memory, temporospacial disorientation, acalculia, perseverations, inadequate behavior and aggressiveness, was presented. The diagnosis of bilateral thalamic infarction was determined by imaging studies, computerized axial tomography and nuclear magnetic imaging. It was concluded that the thalamus lesions accompanied with alterations of the higher psychical functions of demential character are usually bilateral and that it is important to diagnose these complications, since most of them may be treated. It was recommended to undertake periodical neuropsychological studies to know if there is an evolutive recuperation of the cognitive and behavorial disorders, or to finally diagnose a vascular thalamic dementia.