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Portable Thermographic Screening for Detection of Acute Wallenberg's Syndrome

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Atypical Sensory Loss Pattern in an Isolated Thalamic Stroke: A Case Report.

Mariam Tadros¹, David Phrathep^2,3, Emily Lewandowski¹

¹Department of Physical Medicine and Rehabilitation, Lake Erie College of Osteopathic Medicine, Bradenton, USA.

|November 18, 2024

Summary

This case report highlights a rare instance where initial CT scans missed a thalamic stroke. Follow-up MRI was crucial for diagnosing this cerebrovascular accident, emphasizing the need for advanced imaging in subtle neurological cases.

Keywords:

atypical thalamic stroke cerebrovascular accident computed tomography imaging ischemic stroke magnetic resonance imaging thalamic stroke

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Area of Science:

Neurology
Radiology

Background:

Computed tomography (CT) is the primary diagnostic tool for suspected cerebrovascular accidents (CVAs).
Thalamic strokes often present with specific neurological deficits, including hemiparesis and sensory loss.

Observation:

A 51-year-old male presented with left-sided hemiparesthesia and incoordination.
Initial and follow-up brain CT scans were negative for acute abnormalities.
Magnetic resonance imaging (MRI) ultimately identified an ischemic incident in the right thalamus.

Findings:

The patient's presentation of pure hemiparesthesia without facial involvement was atypical for a thalamic lesion.
CT imaging failed to detect the early ischemic changes in the thalamus.

Implications:

This case underscores the limitations of CT in diagnosing subtle cerebrovascular accidents.
It highlights the critical role of MRI in cases with persistent or atypical neurological symptoms despite negative CT findings.
Emphasizes the importance of clinical correlation and considering advanced imaging for accurate diagnosis and timely intervention.