Thalamic Stroke - Oren Zarif - Thalamic Stroke
Thalamic strokes are an affliction of the brain that affects the thalamus and its projections. A stroke to these parts can cause a variety of neurological deficits, including fluctuating levels of consciousness, personality changes, and a lack of insight and spontaneity. Patients may also display impairments in recent memory and new learning. Patients may also show a persistent pattern of thinking, including inappropriate maintenance of semantic categories. They may also demonstrate paraphasic speech, with semantic and phonemic errors common. Left thalamic lesions are associated with acalculia.
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The thalamus is the center of the brain, roughly the size of a walnut. Strokes to the thalamus can be fatal, or have long-term consequences. A thalamic infarct occurs when an area of the brain is deprived of oxygen due to an abnormality in the blood supply. Blood clots can form in these arteries and block the flow of blood to the brain.
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Two methods of analyzing thalamic lesion patterns were used in this study. First, patients' lesion outlines were superimposed on corresponding atlas planes, and their respective thalamic regions with maximal lesion convergence were identified. Next, a colour-coding system was used to identify the thalamic lesion. Once these markers were defined, a lesion outline could be projected onto an axial section of the Morel atlas.
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Another method of analyzing thalamic blood supplies was a single-center study. In TOAST, 23 of 24 thalamic infarcts were classified as SVO and only one as LAA. However, it should be noted that this study was not a comprehensive review of thalamic stroke. Further studies are needed to determine whether the diagnosis of a thalamic stroke is correct. There is no evidence that an SVO is a cause of a thalamic stroke, although a large percentage of such cases were categorized as such.
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Movement disorders after thalamic strokes are common. The most common post-thalamic movement disorders are dystonia and hemiataxia. However, the prevalence of movement disorders in patients following acute thalamic strokes was higher among patients with ischaemic strokes. In addition, patients with acute thalamic stroke were more likely to experience an acute movement disorder. Involvement of the posterior and lateral thalamus was highest, followed by dystonia and asterixis.
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While a diagnosis of a thalamic stroke can be difficult to make, its rapid recognition is essential for secondary prevention. The primary care provider should learn how to evaluate for signs and symptoms of right anterior ITS. The patient's physical examination should be augmented with mental screening tests. And a patient may experience no symptoms at all, making the diagnosis of this a difficult one. For those who don't have a doctor's appointment, a mental screening test may be helpful in identifying a right-sided thalamic stroke.
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The thalamus is an important part of the brain, affecting many aspects of function. It mediates general cortical alerting responses. It also processes sensory information, relaying it to the cortex. Therefore, it is common to experience thalamic stroke alone, or in conjunction with other brain structures. The complex nature of thalami nuclei also induces a wide range of presentation of thalamic stroke. In addition, thalamic stroke is often mistaken for several neurological conditions.
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Spinothalamic dysfunction and lemniscal dysfunction usually coexist. Abnormal LEPs may occur in combination with preserved lemniscal functions, but these conditions are rarely fatal in themselves. They often cooccur in patients with thalamic stroke, but they are not related. When combined with the MRI results, they may be indicative of a thalamic stroke. So, this study aims to identify patients at an increased risk of suffering from thalamic pain.
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The extent to which the thalamic stroke affects memory is unknown. The combined effects of the intralaminar region and the mammillothalamic tract may have a profound effect on memory consolidation processes. A larger thalamic stroke may disrupt the chain of information flow between the diencephalon and the prefrontal cortex, leading to an executive dysfunction. A large proportion of vertebro-basilar infarctions occur in the thalamus, but the extent of the damage is still unclear.
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The prevalence of CPSP is unknown. Only 37 cases were reported in the Lausanne stroke registry. However, this is a higher prevalence than previous studies, highlighting the importance of detecting this condition during the acute phase of a stroke. The late look bias may lead to underreporting of this condition. However, the incidence of asterixis declines over the course of 10 days. Therefore, physicians should monitor thalamic stroke symptoms closely.
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