Neuropsychological deficits after bithalamic hemorrhages
Introduction
Strategic lesions of the thalamus due to infarction or hemorrhage may cause acute or persistent complex neuropsychological dysfunction and may lead to vascular dementia. The most prominent cognitive deficit and one of the most extensively studied is memory dysfunction [1]. Aphasia, neglect and anosognosia were also frequently reported [1], [2], [3].
Bilateral, simultaneous, symmetrical thalamic hemorrhages are unusual causes of thalamic dementia. Kumral and colleagues [4] studied 100 patients with thalamic hemorrhage, but none of them have had bilateral hemorrhages. Bilateral hemorrhages are mostly a consequence of systematic diseases and conditions.
We present clinical, neuropsychological and structural neuroimaging data of the 12-month follow-up period of a man with bilateral thalamic hemorrhages.
Section snippets
Case report
Sixty-year-old, right-handed, Serbian speaking civil engineer (16 years of education) was admitted to Emergency Unit suffering from pancreatitis acuta hemorrhagico-necroticans. After surgery, the patient developed right hemiparesis and coma (Glasgow Coma Scale 5). Computed tomography (CT) and magnetic resonance (MR) of the brain showed medially situated bithalamic hematomas with rupture into the third ventricle. MR angiography was normal. After 2 weeks level of consciousness had improved, but
Discussion
Neuropsychological deficits due to bilateral thalamic infarctions had been reported previously [5], [6]. Bilateral thalamic hemorrhages are very rare and neuropsychological outcome has not been studied yet. We present a patient with pancreatitis acuta hemorrhagico-necroticans, with developed bilateral, simultaneous, medial thalamic hemorrhages secondary to severe coagulopathia.
At the onset of stroke, coma was observed due to disturbance of the arousal system [4].
After 2 weeks, the patient's
Conclusion
Neuropsychological syndrome in our patient with bilateral thalamic hemorrhages was characteristic for subcortico-cortical cognitive deficit and could be caused by disruption of the cortico-thalamic circuits.
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Clinical properties of regional thalamic hemorrhages
2013, Journal of Stroke and Cerebrovascular DiseasesCitation Excerpt :According to Kirshner,17 this condition is a quasiaphasic abnormality of vigilance, and that the thalamus plays a role in alertness of the speech cortex. In addition, some authors have stated that a mass effect leading to compression of the cortex or its vessels, diaschisis, or disconnection and anterior thalamic involvement may cause aphasia in the thalamic hemorrhage.18,19 Positron emission tomography revealed diffuse hypometabolism in the ipsilateral cerebrum (frontal parietal, temporal, occipital, putamen, and thalamus) in subcortical aphasia after intracranial hemorrhage.20
Vascular dementia with left thalamic infarction: Neuropsychological and behavioral implications suggested by involvement of the thalamic nucleus and the remote effect on cerebral cortex. The Osaki-Tajiri project
2013, Psychiatry Research - NeuroimagingCitation Excerpt :The left side effect is thought to be associated with separation of concurrent sounds, contributing to smooth verbal communication in everyday settings (Alain et al., 2005), or syntactic integration of lexical elements in grammatical structure (Dominey et al., 2009). Several studies have also reported the relationship between thalamic lesion and decreased word fluency (Kuljic-Obradovic et al., 2007) or mental flexibility (Swartz et al., 2008). Six patients exhibited depression in this study.
Bilateral thalamic necrosis following ingestion of ridge gourd infested with coelomycete fungi (Diplodia)
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