| Bilateral paramedian thalamic infarct in the presence of an unpaired thalamic perforating artery. | |
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MedLine Citation:
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PMID: 11956945 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Bilateral paramedian thalamic infarction is rare. The suggested mechanism is occlusion of a central unpaired thalamic perforating artery--an anatomic variant. In the few existing reports of this condition, the diagnosis was based on computed tomography (CT) or magnetic resonance imaging (MRI) findings alone. Other causes of thalamic lesions were not ruled out, and there was no angiographic demonstration of the presumed variant artery. We present a case of a 48-year-old man with a bilateral thalamic infarction seen on CT and MRI. Initial neurological examination revealed lethargy, severe combined motor and sensory aphasia, and a mild upward gaze limitation. The patient had no focal motor deficits. After 24 hours, the patient was more alert and his speech became more fluent, but Korsakoff-type amnesia with poor attention span became apparent. The patient improved slowly over 6 months of rehabilitation. Bilateral thalamic lesions can be caused by several conditions. Among those are thiamine deficiency, cerebral lupus, toxoplasmosis, cysticercosis, cerebral syphilitic gumma, and even tumors and fungal infections. All these were ruled out in our case. Superselective digital subtraction angiography (DSA) demonstrated a single unpaired thalamic perforator. To our knowledge, this is the first time this anatomical variant has been demonstrated in vivo in association with bilateral thalamic infarction. |
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Authors:
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B Z Roitberg; E Tuccar; M S Alp |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Acta neurochirurgica Volume: 144 ISSN: 0001-6268 ISO Abbreviation: Acta Neurochir (Wien) Publication Date: 2002 Mar |
Date Detail:
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Created Date: 2002-04-16 Completed Date: 2003-02-12 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0151000 Medline TA: Acta Neurochir (Wien) Country: Austria |
Other Details:
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Languages: eng Pagination: 301-4; discussion 304 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois 60612, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiography, Digital Subtraction Cerebral Angiography Cerebral Infarction / diagnosis* Dominance, Cerebral / physiology* Follow-Up Studies Humans Intracranial Arteriovenous Malformations / diagnosis* Magnetic Resonance Imaging Male Middle Aged Neurologic Examination Thalamic Diseases / diagnosis* Thalamus / blood supply* Tomography, X-Ray Computed |
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