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Atypical Sensory Loss Pattern in an Isolated Thalamic Stroke: A Case Report
Mariam Tadros1, David Phrathep2,3, Emily Lewandowski1
1Department of Physical Medicine and Rehabilitation, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Cureus
|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.
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.
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