open access
Bilateral paramedian thalamic infarction with hypothalamic dysfunction
Affiliations- Chair and Department of Neurology of Medical University of Lublin, Poland
open access
Abstract
Unilateral thalamic lesions cause transient or permanent behavioral, sensory and oculomotor disturbances; bilateral lesions of thalamus result in more severe and longer lasting symptoms. We present an atypical case of bilateral paramedian thalamic infarct with concomitant hypothalamic dysfunction. The only risk factor of ischaemic stroke found in the patient was a short lasting episode of atrial fibrillation. Bilateral paramedian thalamic infarcts may result from occlusion of one paramedian thalamic artery, which arises from the posterior cerebral artery, either with separated or with a common trunk, thus supplying the thalamus bilaterally. Independently of anatomical variants of thalamus blood supply, the most probable cause of infarct in our patient was unilateral or bilateral occlusion of the posterior cerebral artery by cardioembolism, probably in the course of basilar artery occlusion. Hypothalamic dysfunction may accompany thalamic infarcts; thus hypothalamo-pituitary function should be routinely assessed in bithalamic infarcts.
Abstract
Unilateral thalamic lesions cause transient or permanent behavioral, sensory and oculomotor disturbances; bilateral lesions of thalamus result in more severe and longer lasting symptoms. We present an atypical case of bilateral paramedian thalamic infarct with concomitant hypothalamic dysfunction. The only risk factor of ischaemic stroke found in the patient was a short lasting episode of atrial fibrillation. Bilateral paramedian thalamic infarcts may result from occlusion of one paramedian thalamic artery, which arises from the posterior cerebral artery, either with separated or with a common trunk, thus supplying the thalamus bilaterally. Independently of anatomical variants of thalamus blood supply, the most probable cause of infarct in our patient was unilateral or bilateral occlusion of the posterior cerebral artery by cardioembolism, probably in the course of basilar artery occlusion. Hypothalamic dysfunction may accompany thalamic infarcts; thus hypothalamo-pituitary function should be routinely assessed in bithalamic infarcts.
Keywords
ischaemic stroke, bilateral thalamic infarct, hypothalamic dysfunction
About this articleTitle
Bilateral paramedian thalamic infarction with hypothalamic dysfunction
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
279-283
Page views
347
Article views/downloads
818
DOI
10.5114/ninp.2012.29135
Bibliographic record
Neurol Neurochir Pol 2012;46(3):279-283.
Keywords
ischaemic stroke
bilateral thalamic infarct
hypothalamic dysfunction
Authors
Ewa Papuć
Joanna Wojczal
Zbigniew Stelmasiak
Konrad Rejdak
