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Ischemic thalamic infarction in children: clinical presentation, etiology, and outcome
1Department of Neurology, Indiana University Medical School, Indianapolis, USA.
Insights
Clinical features of pediatric thalamic strokes are not well understood. This study reports on six children with ischemic thalamic infarcts, finding that most recovered well, suggesting a good prognosis.
Area of Science:
- Neurology
- Pediatric Neurology
- Vascular Neurology
Background:
- Clinical features of thalamic strokes in children are not well-defined.
- Thalamic infarcts can result from various etiologies and present with diverse neurological deficits.
Purpose of the Study:
- To delineate the clinical features, etiologies, and outcomes of ischemic thalamic infarcts in children.
- To assess the prognosis of thalamic strokes in the pediatric population.
Main Methods:
- Retrospective case series of six pediatric patients (age 21 months to 14.5 years) with confirmed ischemic thalamic infarcts.
- Review of clinical presentations, neuroimaging findings, etiological factors, and follow-up data.
Main Results:
- Six children (3 male, 3 female) experienced ischemic thalamic infarcts.
- Presentations varied based on affected thalamic artery territory, including decreased consciousness, hemiparesis, ocular motility abnormalities, and aphasia.
- Etiologies included infectious vasculitis, congenital heart disease, migraine, trauma, and unknown causes.
- Of five patients with follow-up, four recovered completely, and one had a residual neurologic deficit.
Conclusions:
- Ischemic thalamic strokes in children can present with diverse clinical manifestations.
- The identified etiologies are varied, highlighting the importance of a comprehensive diagnostic workup.
- The prognosis for pediatric ischemic thalamic strokes appears relatively favorable, with most patients achieving good recovery.
Abstract:
Clinical features of thalamic strokes have not been well delineated in children. Six children with ischemic thalamic infarcts (3 M, 3 F; age range: 21 months to 14 1/2 years) are reported. Three patients had infarction in the thalamoperforate artery territory and all had a decreased level of consciousness and hemiparesis; two of them also had associated ocular motility abnormalities. One patient with left thalamotuberal artery stroke presented with aphasia. Two patients with thalamogeniculate artery infarcts had hemiparesis and involvement of the posterior cerebral artery. Etiologic factors in our patients were: infectious vasculitis, congenital heart disease, migraine, and unknown in 1 patient each and trauma in 2 patients. Follow-up information was available for 5, 4 of whom recovered completely. One patient was left with a neurologic deficit. We conclude that the prognosis of ischemic thalamic strokes in children is relatively good.