The acute behavioral syndrome of anterior thalamic infarction: A prospective study of 12 cases

Ghika-Schmid, Florence; Bogousslavsky, Julien

doi:10.1002/1531-8249(200008)48:2<220::aid-ana12>3.0.co;2-m

Cited by 177 publications

(75 citation statements)

References 30 publications

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“…The biggest of them is the centromedian nucleus, which is an essential part of the ascending reticular system (truncothalamic activation system), because the mesopontin fibres of the formatio reticularis terminate there [8]. Control of vigilance by thalamic pathways could be replaced by extrathalamic projections, and there are only a few reports concerning the prognosis of bilateral paramedian thalamic infarcts [1,12,16,22]. In the present study, 50% of the patients with bilateral PTPA infarcts had persistent impairment of vigilance.…”

Section: Discussionmentioning

confidence: 65%

“…Due to functional diachisis of the bi-directional connections of the prefrontal, orbitofrontal and anterior cingulate cortex, the clinical features of akinetic mutism and lethargic states are quite similar to those seen in lesions of frontal lobe and anterior cingulate cortex [12,14,21]. Caused by diachisis of the mamillothalamic tract (Vicq d' Azyr fibres) and the anterior part of the internal medullary lamina, severe amnesia similar to Korsakoff's psychosis may also occur as a main feature after improvement of initial hypersomnia [1,12,44]. In these cases, MR imaging often emphasised involvement of the anterior thalamic group and the anterior part of the internal medullary lamina in the TTA territory [12].…”

Section: Discussionmentioning

confidence: 99%

“…Variations of vascular supply of the thalamus are frequent, thus making the attribution of individual vascular occlusion patterns to clinical deficiency symptoms and infarcts demonstrated by MRI rather difficult [12]. Besides different sizes of thalamoperforating arteries, the volume of infarcts and PWI/DWI mismatch depend on the extent of collateralisation.…”

Section: Discussionmentioning

confidence: 99%

“…Disorientation [1,2] artery [1,2] Ventral internal Amnestic syndromes [1,2,12] Anterior thalamosubthalamic medullary lamina Apathy [21] paramedian artery [4] Mamillothalamic tract Perseverative behaviour [12] Premamillary branch of thalamotuberianpedicle [6] Inferior thalamic peduncle [7] Inferomedial Posterior Thalamoperforating pedicle [6] P1-segment of PCA Dorsomedial ncl.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of paramedian thalamic infarcts: MR imaging, clinical features and prognosis

et al. 2004

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Considering the highly variable vascular supply of the thalamic nuclei, MRI and clinical syndromes can be heterogeneous in ischemic diseases. We attempt to determine MRI pattern and to analyse neurological features and prognosis of paramedian infarcts. In a prospective case series within 5 years from 1999 to 2003, MRI, MRA and clinical symptoms of 38 consecutive patients were analysed. The inferomedial (posterior thalamoperforating artery) territory was affected in 89%, and lesions in the anterolateral (tuberothalamic artery) territory occurred in 42%. However, definite attribution to anterolateral or inferomedial territories was not possible in 13%. Neurological manifestations were somnolence (87%), hemisyndromes (79%), cognitive deficits (58%), oculomotor nerve palsies (53%) and vertical gaze palsies (39%). The most common aetiologies were cardiac embolism (42%), intraarterial embolism (16%), small vessel disease (13%) and large artery arteriosclerosis (13%). Pathological MRA findings were encountered in 55%, and in 18%, lesions were only visible on diffusion-weighted imaging. Correlation of MRI pattern and neurological symptoms points out anterolateral thalamic lesions as the cause of amnestic deficits. Intracranial MRA allows a non-invasive prediction of basilar tip occlusion. Our results underline the necessity of additional diffusion-weighted imaging in detecting small thalamic and midbrain lesions.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of paramedian thalamic infarcts: MR imaging, clinical features and prognosis

et al. 2004

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“…Auch Stuss et al [36] und Rousseaux et al [29] beschreiben jeweils einen Fall nach links thalamischen Läsionen, die beide verbale Gedächtnisstörungen aufwiesen. Ghika-Schmid und Bogousslavsky [6] berichten über 12 Patienten mit lakunären anterioren thalamischen Infarkt, 8 linksseitig, 4 rechtsseitig, bei allerdings hohem Lebensalter (63±19 Jahre).Alle hatten anterograde Gedächtnis-störungen, die linksseitigen primär verbal, die rechtsseitigen primär visuoräumlich.…”

Section: Gedächtnisstörungen Nach Unilateralen Dienzephalen Läsionenunclassified

Gedächtnisstörungen nach unilateralen zerebralen Läsionen

2002

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In contrast to the amnestic syndrome, unilateral hemispheric lesions are mostly connected with selective memory deficits, which are related to either verbal or visual-spatial information. Clinical studies concerning this are mostly about patients with temporal lobe epilepsy. Almost all studies found that significantly worse verbal memory deficits appeared before or after left temporal lobectomy. In contrast to these outcomes, the results concerning right temporal lobectomy (RTL) are nonuniform. There are studies that cannot prove figurative memory deficits before or after RTL and others that ascertain a correlation between RTL and figurative memory deficits. Mean values are always compared with random samples of left and right hemispheric patients. In contrast, the presented study assumes a clinical isolated case and analyses a random sample of neurological patients with different genesis with a standardized memory test (Berlin Amnesia Test, or BAT). As a result, a significant correlation between left hemispheric lesions and verbal memory deficits as well as right hemispheric lesions and visual-spatial memory deficits can be proven. Possible reasons for these differing results with visual-spatial memory deficits are still under discussion.

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Chronic Cognitive Impairment Following Laterothalamic Infarcts

Annoni¹,

Khateb²,

Gramigna³

et al. 2003

Arch Neurol

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Our observations show that while learning, naming, and gnosic difficulties fit with the classical verbal/nonverbal dichotomy (left and right hemisphere, respectively), executive dysfunctions, including verbal fluency tasks, were more dominant after right thalamic infarcts. Although the observed deficits appeared to be less severe than those generally found with dorsomedial and polar thalamic strokes, the dominance of executive dysfunction suggests that ventrolateral thalamic lesions may disrupt frontothalamic subcortical loops.

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The acute behavioral syndrome of anterior thalamic infarction: A prospective study of 12 cases

Cited by 177 publications

References 30 publications

Assessment of paramedian thalamic infarcts: MR imaging, clinical features and prognosis

Assessment of paramedian thalamic infarcts: MR imaging, clinical features and prognosis

Gedächtnisstörungen nach unilateralen zerebralen Läsionen

Chronic Cognitive Impairment Following Laterothalamic Infarcts

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