Background: The study aimed to evaluate the clinical features in patients with bilateral and unilateral paramedian thalamic infarcts. Methods: Twenty-one patients with paramedian thalamic infarcts were included, and their case records were reviewed. We focused on the patients' neuroimaging and neurological symptoms including the duration of coma, vertical gaze palsy, and memory impairment. The causes of bilateral and unilateral paramedian thalamic infarcts were also investigated. Result: Nine patients had bilateral paramedian thalamic infarcts and 12 patients had unilateral lesions. As an initial symptom, coma had occurred in 5 patients with bilateral lesions and 4 patients with unilateral lesions. Bilateral vertical gaze palsy and memory impairment were found in both groups. Most of them recovered well, except 1 patient who died due to bilateral thalamic paramedian infarction. Conclusions: Our results show that both bilateral and unilateral paramedian thalamic infarcts can cause coma, vertical gaze palsy, and memory impairment. This may promote our understanding of paramedian thalamic infarction.

Abstract Background: The study aimed to evaluate the enhanced three-dimensional brain volume magnetic resonance imaging (3D-BRAVO) in the diagnosis of Tolosa-Hunt syndrome (THS). Methods: we described 21 patients with THS and their case records including clinical syndromes and neuroradiologic features by conventional MRI and enhanced 3D-BRAVO. Results: 19 patients showed enhancement in the cavernous sinus through 3D-BRAVO. 16/19had ipsilateral enhanced lesions involved 4-10 continuous slices in cavernous sinus on 3D-BRAVOscan. Both local size enlargements and enhancement in the cavernous sinus were found in 3 patients. The rest 2 patients performed negative results on neither conventional MRI nor enhanced 3D-BRAVO. Conclusions: enhanced 3D-BRAVO imaging demonstrated a high detection rate in the cavernous sinus, which may promote our understanding ofTolosa-Hunt syndrome.