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Simultaneous bilateral thalamic hemorrhage: case report.

I Sunada1, H Nakabayashi, Y Matsusaka

  • 1Department of Neurosurgery, Saiseikai Ibaraki Hospital, Osaka, Japan.

Radiation Medicine
|December 11, 1999
PubMed
Summary
This summary is machine-generated.

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This extremely rare case highlights simultaneous hypertensive bilateral thalamic hemorrhage. Bilateral thalamic bleeds indicate a worse prognosis than hemorrhage size alone suggests.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Hypertensive hemorrhage is a common cause of stroke.
  • Thalamic hemorrhages are less common than other intracerebral hemorrhages.
  • Bilateral thalamic hemorrhages are exceptionally rare.

Observation:

  • A 60-year-old man presented with symptoms of a stroke, including left hemiparesis, headache, and deteriorating consciousness.
  • Computed tomography (CT) confirmed bilateral thalamic hemorrhages 17 hours after symptom onset.
  • Magnetic resonance imaging (MRI) revealed bilateral thalamic lesions with similar signal intensities, suggesting simultaneous onset without a clear underlying hemorrhagic cause.

Findings:

  • The patient experienced neurological deterioration, progressing to tetraparesis.

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  • Conservative treatment led to some neurological improvement.
  • The patient ultimately succumbed to pneumonia six months post-onset.

    • Implications:

    • Simultaneous bilateral thalamic hemorrhage is an extremely rare presentation of hypertensive stroke.
    • The prognosis for patients with bilateral thalamic hemorrhages appears to be poorer than predicted solely by lesion size.
    • This case underscores the importance of considering rare etiologies and the severity associated with bilateral thalamic involvement in hypertensive emergencies.