What is a Thalamic Stroke? - Oren Zarif - Thalamic Stroke
A thalamic stroke is a devastating neurological disorder that damages the anterior thalamus. This structure relays sensory and motor information to the cerebral cortex. Damage to the anterior thalamus may lead to neuropsychological disturbances. These symptoms may be acute, lasting hours or days, and may include decreased level of consciousness, agitation, and aggression. The patient may also exhibit decreased responsiveness to touch. This type of stroke is particularly difficult to diagnose, and there is currently no single, definitive treatment.
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A thalamic stroke affects language and may result in reduced verbal output, impaired fluency, and impairment of comprehension. Both patients exhibit impairments in verbal memory and other cognitive functions. In particular, patients with lesions in the left thalamic region may exhibit impaired verbal memory and poor semantic and phonetic skills. The impairments, however, may not be as evident in right-sided lesions. A thalamic stroke can also affect other areas of the brain.
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A male patient with a thalamic infarct presented with varying levels of consciousness and facial paresthesia. On examination, he was found to have a right thalamic paramedian infarct, as well as arterial hypertension. Though thalamic infarcts are not common, they are more often a result of other structural or metabolic disorders of the brain. Infarcts in the thalamus are often accompanied by central pontine myelinolysis, while infarctions affecting both sides of the brain are called Wernicke encephalopathy.
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A thalamic stroke is a type of brain injury where the affected area in the thalamus does not receive proper blood flow. The afferents usually have a limited amount of brain damage. Infarctions in the polar artery territory are the most common thalamic infarcts. While these strokes are rare, they are still a cause for alarm. In such cases, treatment of the brain injury should focus on the prevention and management of these neurological injuries.
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Patients who suffer from a thalamic infarct usually have other types of strokes in the brain. While this type of stroke is rare, some studies have described similar symptoms to those seen in paramedian cerebral artery infarct. A patient's symptoms may include altered consciousness, asymmetrical vertical gaze paresthesia, and cognitive disturbance. While the exact cause of the stroke remains unknown, it is important to understand how it develops.
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Left-sided thalamic stroke patients are admitted to hospitals at a higher rate than those with right-sided thalamic stroke. Patients with a left-sided thalamic stroke also have a higher prevalence of ITS lesions in the left anterior thalamus. The lesion map may help to visualize the asymmetric distribution of lesions in the anteromedian thalamic vascular territories. Symptoms of a thalamic stroke may also include neuropsychological signs such as language impairments. Patients with a left-sided thalamic stroke do not have an increased risk of developing a lacunar syndrome.
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The more recognizable symptoms of left-sided thalamic stroke may reduce the number of ITS admissions in the prehospital setting. However, the diagnosis of this subgroup of patients may be missed if the underlying complication is not identified early enough. This lack of recognition could compromise patient care by delaying appropriate treatment and secondary prophylaxis. Therefore, more research is needed to define the clinical characteristics of left-sided thalamic infarcts and identify suitable diagnostic instruments.
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In vivo neuroimaging has also contributed to the current understanding of thalamic function. This method has led to advances in the anatomic precision of MRI compared to CT. Many in vivo neuroimaging techniques have been instrumental in identifying lesions in the thalamus. This method has made significant contributions to our understanding of the thalamus' role in behavior and mental health. There are more studies of thalamic lesions than ever before.