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Bilateral thalamic infarction. Clinical, etiological and MRI correlates
E Kumral1, D Evyapan, K Balkir
1Department of Neurology, Faculty of Medicine, Ege University, Izmir, Turkey. ekumral@med.ege.edu.tr
Acta Neurologica Scandinavica
|January 12, 2001
Summary
Bilateral thalamic infarction is rare, occurring in 0.6% of ischemic stroke cases. Specific clinical patterns, like consciousness disorders and sensory loss, can help diagnose these strokes before imaging.
Area of Science:
- Neurology
- Neuroscience
- Radiology
Background:
- Bilateral thalamic infarction is an uncommon stroke subtype.
- Understanding its patterns is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the clinical, behavioral, topographic, and etiological patterns of simultaneous bilateral thalamic infarction.
- To identify specific diagnostic markers and outcomes associated with different thalamic artery territories.
Main Methods:
- Retrospective study of 16 patients with bilateral thalamic infarction over 7 years.
- Analysis of computed tomography (CT) and magnetic resonance imaging (MRI) findings.
- Correlation of neuroimaging with clinical and etiological data.
Main Results:
- Bilateral thalamic infarction represented 0.6% of ischemic stroke cases.
- Four topographic patterns were identified based on affected thalamic artery territories.
- Specific clinical syndromes were associated with different infarction patterns: paramedian (consciousness, memory, gaze palsy, psychic changes) and thalamogeniculate (sensory loss).
- Small artery disease was the primary cause, followed by cardioembolism.
Conclusions:
- Bilateral thalamic infarction, though rare, presents with distinct clinical and neuroimaging patterns.
- Clinical presentation can suggest the topographic pattern and affected arteries, aiding in early diagnosis.
- Cognitive outcomes varied based on the infarction territory, with paramedian infarcts showing more stable cognitive function post-stroke.