What Are the Symptoms of a Thalamic Stroke? - Oren Zarif - Thalamic Stroke

The thalamus is an intricate part of the brain. It sits deep in the center of the brain and is about the size of a walnut. The symptoms of a thalamic stroke are varied and may be the result of a clot blocking blood flow or bleeding from a blood vessel in the thalamus. A thalamic stroke may be fatal or mildly disabling. Fortunately, recovery after a thalamic stroke is possible for many patients.

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Although the thalamus plays an important role in several brain functions, it is often overlooked in stroke cases. This structure is involved in general cortical alerting responses and processes sensory information before relaying it to the cortex. Although thalamic strokes are relatively rare, they are often associated with other brain structures. The functional complexity of the thalami nuclei results in wide variation in the presentation of the symptoms of the disease. In addition, thalamic disease may resemble several other neurological conditions.

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MRIs of patients with a thalamic infarct are also useful in diagnosis. Bogousslavsky J, Dejerine E, and Levasseur M studied patients who experienced infarctions in the thalamus and adjacent central aspects of the midbrain. These studies confirmed that infarcts in the thalamus are associated with speech disorders. The most common types of infarctions are inferolateral (ipv) territory infarctions, followed by paramedian and anterior (PA).

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Left thalamic lesions produce language deficits, primarily in the left hemisphere. The patient may display reduced verbal fluency, as well as hyperphonic speech. Language impairment is associated with a persistent lack of insight, and patients often display difficulty with verbal learning and memory. They are also more likely to exhibit perseverative behaviors and inappropriate maintenance of semantic categories. The left thalamic lesions often lead to acalculia.

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The causes and treatment of thalamic infarction have not been identified in a significant proportion of patients. The disease is rare but can be fatal and require amputation of a thalamus. It may even be caused by a stroke from a different area of the brain. This condition is associated with a lower-than-average risk of developing Alzheimer's disease. However, if left untreated, a thalamic infarct can cause lasting damage to a patient's memory.

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A large majority of thalamic infarcts can be classified as either an SVO or a LAA. To further improve our understanding of thalamic stroke, vascular imaging may be helpful to rule out other vascular pathologies. For instance, a small ischemic lesion may cause the posterior communicating artery to arise either before or after the medial choroidal artery, while a single paramedian artery may be the source of an infarction.

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Neurologists may find it easier to identify a thalamic stroke if a patient has a dominant hemispheric stroke, but they may not be aware of the symptoms in the corresponding dominant hemispheric lesions. Although more patients with left-sided strokes are hospitalized than those with right-sided lesions, the vast majority of these patients will not exhibit any signs of this disease. The primary symptom of a thalamic stroke is impaired verbal memory.

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The emergence of more recognizable symptoms in the left and right anterior ITSs may have a major impact on the frequency of thalamic stroke admissions. However, currently available screening methods may miss the diagnosis of a right anterior thalamic infarction, which could result in a missed diagnosis and consequent delayed treatment. Further studies are needed to identify the diagnostic instruments for this condition. There are several risk factors associated with thalamic stroke and their recognition is vital to early treatment.

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The arteries in the paramedian territory supply several thalamic nuclei. The paramedian artery is an artery that arises from the P1 Cerebral Posterior artery. A thalamic infarction in this region of the brain can result in severe neuropsychological and behavioral effects. The patient can experience decreased arousal and reduced level of consciousness. In addition, a patient may experience depression, agitation, aggression, or apathy.