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Neurological picture
Single thalamic-subthalamic artery and bilateral thalamic infarcts
  1. JULIO CHALELA,
  2. ERIC RAPS
  1. Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
  1. Dr Julio Chalela Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia PA 19104—4283, USA. Telephone 001 215 662 3647; emailJchalela{at}mail.med.upenn.edu
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http://dx.doi.org/10.1136/jnnp.67.1.119

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    Figure1

    Axial T2 weighted image showing bilateral symmetric high signal intensity signal in the territory of the thalamic- subthalamic artery.

    A 68 year old woman developed intermittent somnolence and dysarthria. Four days later she was alert but disoriented and developed stereotypic behaviours such as constantly packing her belongings. Brain MRI showed bilateral symmetric thalamic infarcts. Magnetic resonance angiography and an echocardiogram were normal.

     In one third of patients, the thalamic-subthalamic arteries arise from one side or from a common pedicle. In such cases an acute occlusion will lead to bilateral posteromedial thalamic infarcts that can be followed by a thalamic dementia.1

    References

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    Journal of Neurology, Neurosurgery, and Psychiatry