Aphasia and unilateral spatial neglect due to acute thalamic hemorrhage: clinical correlations and outcomes

Abstract

Thalamic hemorrhages are associated with a variety of cognitive dysfunctions, and it is well known that such cognitive changes constitute a limiting factor of recovery of the activities of daily living (ADL). The relationship between cognitive dysfunction and hematomas is unclear. In this study, we investigated the relationship between aphasia/neglect and hematoma volume, hematoma type, and the ADL. One hundred fifteen patients with thalamic hemorrhage (70 men and 45 women) were studied. Their mean age was 68.9 ± 10.3 years, and patients with both left and right lesions were included. We calculated hematoma volume and examined the presence or absence of aphasia/neglect and the relationships between these dysfunctions and hematoma volume, hematoma type, and the ADL. Fifty-nine patients were found to have aphasia and 35 were found to have neglect. Although there was no relationship between hematoma type and cognitive dysfunction, hematoma volume showed a correlation with the severity of cognitive dysfunction. The ADL score and ratio of patient discharge for patients with aphasia/neglect were lower than those for patients without aphasia/neglect. We observed a correlation between the hematoma volume in thalamic hemorrhage and cognitive dysfunction. Aphasia/neglect is found frequently in patients with acute thalamic hemorrhage and may influence the ADL.

Endoscopic surgery for thalamic hemorrhage breaking into ventricles: Comparison of endoscopic surgery, minimally invasive hematoma puncture, and external ventricular drainage

“…Firstly, because the thalamus is inside the internal capsule separated from the lateral and third ventricles only by the ventricular wall, the hematoma usually extends into the ventricular system, damages the posterior limb of the internal capsule, and compresses the midbrain and cerebral aqueduct, which can lead to acute obstructive hydrocephalus, paralysis, or even death. Secondly, the effects of the thalamic hematoma (especially of those over 10 mL) and its associated edema progress over time, resulting in secondary injury and neurological deterioration after the first day 21, 22. Examples include the occurrence of chronic hydrocephalus caused by long periods of poor cerebrospinal fluid circulation and the toxic effects of blood decomposition products on the ventricular wall 6 .…”

Unilateral Spatial Neglect Due to Stroke

“…USN is thought to present in approximately 40% of cases with right hemisphere injury (5)(6)(7)(8)(9)(10)(11). Reports show that approximately 80% of patients with right hemisphere injury from acute stroke display USN (12)(13)(14)(15). This variation may be due to differences in the underlying cause of the lesions, time from the onset, and evaluation methods (Table 1).…”

Aphasie nach ischämischem Hirninfarkt im links anterioren Thalamus

“…Neben Läsionen in subkortikalen Fasertraktverbindungen sind auch aphasische Störungen nach Thalamusläsionen bekannt. Diese werden nach ischämischen und hämorrhagischen Thalamusläsionen, aber auch nach Tumoren und Abszessen im Thalamus beschrieben [7][8][9].…”