Anteromedial thalamic infarct: a rare presentation.

Area of Science:

• Neurology
• Neuroimaging
• Vascular Neurology

Background:

• Thalamic infarcts can present with diverse neurobehavioral and ocular motor deficits.
• Anteromedial thalamic lesions are less common but can lead to specific symptom clusters.
• Understanding rare presentations is crucial for accurate diagnosis and management.

Observation:

• A 50-year-old woman presented with acute left eye ptosis, vertical gaze paresis, and confusion.
• Magnetic Resonance Imaging (MRI) revealed an acute left anteromedial thalamic infarct.
• Severe left P1 segment stenosis was identified as a likely underlying cause.

Findings:

• The patient's symptoms, including ptosis and gaze palsy, align with rare presentations of thalamic infarcts.
• Anteromedial thalamic lesions are associated with a spectrum of neurobehavioral and ocular motor deficits.
• The co-occurrence of infarct and significant P1 stenosis suggests a potential embolic or hemodynamic mechanism.

Implications:

• This case underscores the importance of considering thalamic infarcts in the differential diagnosis of acute neurological deficits.
• Understanding these rare presentations aids in accurate diagnosis and management of cerebrovascular events.
• Further research into the specific mechanisms and clinical spectrum of thalamic strokes is warranted.