What Are the Symptoms of a Thalamic Stroke? - Oren Zarif - Thalamic Stroke
A thalamic stroke is a rare type of stroke, with symptoms ranging from altered consciousness to cognitive disturbance. This disorder can be caused by occlusion of the artery of Percheron, which originates from the proximal posterior cerebral artery. It causes bilateral medial thalamic infarction and manifests with altered consciousness, vertical gaze paresis, and cognitive disturbance. This type of stroke may mimic a more common condition, the top of basilar syndrome.
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A thalamic stroke can also cause speech and communication difficulties. The brain relays 98% of sensory input. If this area of the brain is damaged, it can cause issues with sensation and sleep, including numbness and tingling. It can also cause hemispatial neglect, in which the opposite side of the body is ignored. Some individuals also suffer from double vision, or hemianopia, in which one half of their visual field is missing.
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MRIs are also helpful in the diagnosis of thalamic stroke. In a recent study by Bogousslavsky J, a thalamic infarct was observed in a patient with a primary complaint of altered mental status. MRIs were negative, but a lumbar puncture was scheduled for further evaluation. The patient's condition improved after the MRI, and an invasive vascular diagnosis was made.
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Researchers are now better able to differentiate between these types of strokes. Paramedian thalamic infarction is a particular case, and it is likely underdiagnosed. Deep cerebral venous thrombosis (DCVT) has been associated with thalamic lesions and neuropsychological symptoms. This type of stroke should be considered in the differential diagnosis of intracranial artery occlusion.
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A CT scan, which combines X-rays with computer images, can identify problems with the arteries and blood vessels. An MRI, which uses radio waves and strong magnets, can produce detailed pictures of the inside of the body. Treatment for a thalamic stroke may include medications such as tPA and aspirin, which can dissolve blood clots. A stroke survivor may have some permanent symptoms as a result.
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In vivo neuroimaging is a valuable tool for determining a patient's thalamic function. MRI has become an invaluable tool for detecting brain lesions, but this method is not always available in clinical practice. However, this technique is more sensitive than CT, and it is an improvement over both. Although the latter technique is still the best method, a CT scan is often not an accurate reflection of the brain's anatomy.
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This study examined the blood supply of the thalamus in 24 patients. Twenty-four of the patients had SVO and one patient had a combination of SVO and LAA arteries. Despite the lack of clinical evidence, most patients were able to return to their normal lives after treatment. A significant portion of patients recovered from their thalamic stroke after controlling risk factors. The researchers found that two-thirds of patients had a good clinical outcome, regardless of which arterial territory they had infarcted.
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This type of thalamic stroke is characterized by severe mnestic-processing deficits in patients with left polar thalamic infarction. The combined damage of the mammillothalamic tract and the medial lobe may disrupt the information flow between the diencephalon and prefrontal cortex, resulting in the symptoms of disconnection-syndrome. If a larger thalamic stroke causes such impairments, the patient may become completely disoriented, unable to make decisions, or experience difficulty with language and communication.
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In the past, research into the role of the thalamus in memory has relied on individual case studies. In the present study, however, a large group of patients were included, as well as several replications with different measurement methods. Results were consistent across subjects, challenging the current thalamic model. In addition, these results are relevant for evaluating the effects of the disorder on verbal memory and recollective recognition, which may be impaired even in thalamic stroke.
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While the cause of thalamic stroke is unknown, the vascular syndromes resulting from ischemic lesions in the thalamus represent a unique example of the mechanism by which the thalamus communicates with the cerebral cortex. Interestingly, thalamic infarcts are rare and typically associated with cardioembolic or small vessel disease. The neurological deficits seen in such cases vary, with the severity of the disease often dependent on the specific thalamic structures involved.
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The symptoms of thalamic stroke vary between patients, but they can be similar: a weakened sense of balance, difficulty with movement and speech, and visual loss. Treatment focuses on addressing the underlying cause of the stroke and extensive rehabilitation. A thalamic stroke is a life-altering condition, and the road to recovery is long and difficult for the patient, and the lives of family members are affected as well. However, recent advances in stroke care have allowed many patients to return to healthy, fulfilling lives.
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