Thalamic Stroke - Oren Zarif - Thalamic Stroke
Thalamic stroke is a neurological disorder that affects the thalamus, the area of the brain responsible for relaying 98% of sensory input. People suffering from thalamic stroke have difficulties with their sense of touch, numbness, tingling sensations, and memory. People also experience changes in personality and attention. They may have difficulty with language and memory. Some people may develop personality changes after a thalamic stroke.
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There are 4 main vascular syndromes that can be characterized by thalamic stroke. Although they are based on the vascular anatomy of the thalamus, stroke syndromes are not specific to any one nucleus. Even though small focal ischemic lesions usually do not involve the nuclear boundaries, studies have shown that they are predominantly microangiopathic. The association between these vascular syndromes and behaviorally defined regions of the cerebral cortex suggests that these strokes are associated with a higher mortality rate.
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A thalamic stroke is caused by a blockage of blood flow in the thalamus, an area of the brain involved in speech, balance, motivation, and sensations. Treatments for thalamic stroke focus on treating the underlying cause and thorough rehabilitation. Because thalamic stroke is so severe, the road to recovery is long, but recent advances in stroke care have enabled many people to lead productive lives after their thalamic stroke.
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In more than half of patients, spinothalamic dysfunction is associated with lemniscal dysfunction. This is different from brainstem lesions and parasylvian infarcts. Because of this, patients with thalamic stroke often present with both spinothalamic and lemniscal symptoms. The difference between the two tracts is most likely due to the small distance between their thalamic projections.
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Two complementary methods were used to analyze the thalamic lesion sites. In one, the outlines of the lesion in each patient were superimposed on corresponding atlas planes, delineating the thalamic regions where the lesions were most convergent. The other method involved colour-coding the thalamic nucleus. One group of patients was evaluated using a more detailed method of thalamic stroke analysis.
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Although morphological and functional data are important in determining the severity of thalamic stroke, the role of sensory signs in predicting thalamic pain is unclear. Nonetheless, CPSP has been linked to pain in stroke patients. This finding is consistent with previous findings. In addition to CPSP, thalamic pain has been associated with thermal dysregulation. This study provides valuable evidence that rehabilitation can influence recovery.
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Despite its rarity, thalamic infarcts are not uncommon. The most common types of thalamic stroke are thalamic infarction and polar artery territory infarction. These cases are particularly important because the patient may not have been aware of his or her condition. A patient with thalamic infarction must have a vascular diagnosis of the affected region. The MRI is the most accurate diagnostic tool in assessing the severity of thalamic stroke.
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MRI data can be used to identify patients with increased risk of developing pain after thalamic stroke. Functional and morphological analyses may be useful in identifying patients with a higher risk of developing thalamic pain. Furthermore, the findings of the present study are reproducible. They suggest that neuro-functional evaluation combined with anatomy-based studies can improve diagnostic accuracy. This is a promising approach. This study also shows that functional investigations of spinothalamic areas can be used to differentiate patients with thalamic pain.
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Previously, the human literature relied on case studies, but recent research has shown that a good-sized group of patients with thalamic infarctions show a significant difference in brain damage in terms of recent memory and new learning. Left-sided lesions show greater impairment in memory, while right-sided lesions are less likely to affect memory. Moreover, the authors' findings are consistent across all subjects, challenging the prevailing thalamic models.
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