Bilateral thalamic infarction in a patient with factor V Leiden mutation

In a 50-year-old unresponsive man with ophthalmoplegia, bilateral thalamic infarction was detected on magnetic resonance imaging of the brain. A thorough evaluation, including urinalysis, laboratory studies, computed tomography of the brain, chest radiography, lumbar puncture, magnetic resonance angiography, cerebral angiography, carotid ultrasonography, and transesophageal echocardiography, revealed no obvious predisposing factors other than heterozygous factor V Leiden mutation. To our knowledge, this is the first reported case of bilateral thalamic infarction associated with factor V Leiden mutation. Physicians should consider the possibility of this mutation in patients with ischemic stroke if no other source is evident.