Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1987 Jul;50(7):900–909. doi: 10.1136/jnnp.50.7.900

Bilateral paramedian thalamic artery infarcts: report of eight cases.

M Gentilini, E De Renzi, G Crisi
PMCID: PMC1032130  PMID: 3625213

Abstract

Eight consecutive patients with CT scan evidence of a bilateral infarct in the territory of the paramedian thalamic artery are reported. In seven cases the infarct also extended to the territory of the polar artery. The main symptoms were: disorder of vigilance which cleared in a few days, and hypersomnolence which lasted longer and in two patients was still present a year later; amnesia, detectable clinically in four patients and only with tests in two patients, which persisted in one patient for three years; changes of mood and bulimia present in five and four patients respectively; and vertical gaze paresis in five patients. Only one patient died, and in the remainder the symptoms tended to subside, but none of the patients who could be followed-up for a year returned to normal behaviour. Clinical and CT scan correlations pointed to the mammillo-thalamic tract as the structure whose damage was responsible for the memory disorders.

Full text

PDF
903

Images in this article

904Image
on p.904
905Image
on p.905
905Image
on p.905

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barbizet J., Degos J. D., Louarn F., Nguyen J. P., Mas J. L. Amnésie par lésion ischémique bi-thalamique. Rev Neurol (Paris) 1981;137(6-7):415–424. [PubMed] [Google Scholar]
  2. Büttner-Ennever J. A., Büttner U., Cohen B., Baumgartner G. Vertical glaze paralysis and the rostral interstitial nucleus of the medial longitudinal fasciculus. Brain. 1982 Mar;105(Pt 1):125–149. doi: 10.1093/brain/105.1.125. [DOI] [PubMed] [Google Scholar]
  3. Castaigne P., Lhermitte F., Buge A., Escourolle R., Hauw J. J., Lyon-Caen O. Paramedian thalamic and midbrain infarct: clinical and neuropathological study. Ann Neurol. 1981 Aug;10(2):127–148. doi: 10.1002/ana.410100204. [DOI] [PubMed] [Google Scholar]
  4. Dehaene I. Bilateral thalamo-subthalamic infarction. Acta Neurol Belg. 1982 Sep-Oct;82(5):253–261. [PubMed] [Google Scholar]
  5. Graff-Radford N. R., Damasio H., Yamada T., Eslinger P. J., Damasio A. R. Nonhaemorrhagic thalamic infarction. Clinical, neuropsychological and electrophysiological findings in four anatomical groups defined by computerized tomography. Brain. 1985 Jun;108(Pt 2):485–516. doi: 10.1093/brain/108.2.485. [DOI] [PubMed] [Google Scholar]
  6. Guberman A., Stuss D. The syndrome of bilateral paramedian thalamic infarction. Neurology. 1983 May;33(5):540–546. doi: 10.1212/wnl.33.5.540. [DOI] [PubMed] [Google Scholar]
  7. Halmagyi G. M., Evans W. A., Hallinan J. M. Failure of downward gaze: the site and nature of the lesion. Arch Neurol. 1978 Jan;35(1):22–26. doi: 10.1001/archneur.1978.00500250026005. [DOI] [PubMed] [Google Scholar]
  8. Leichnetz G. R. The prefrontal cortico-oculomotor trajectories in the monkey. J Neurol Sci. 1981 Mar;49(3):387–396. doi: 10.1016/0022-510x(81)90029-0. [DOI] [PubMed] [Google Scholar]
  9. Mills R. P., Swanson P. D. Vertical oculomotor apraxia and memory loss. Ann Neurol. 1978 Aug;4(2):149–153. doi: 10.1002/ana.410040209. [DOI] [PubMed] [Google Scholar]
  10. Percheron G. Les artères du thalamus humain. I.--Artère et territoire thalamiques polaires de l'artère communicante postérieure. Rev Neurol (Paris) 1976 May;132(5):297–307. [PubMed] [Google Scholar]
  11. Percheron G. Les artères du thalamus humain. II.--Artères et territoires thalamiques paramédians de l'artère basilaire communicante. Rev Neurol (Paris) 1976 May;132(5):309–324. [PubMed] [Google Scholar]
  12. Percheron G. Les artères du thalamus humain. Les artères choroïdiennes. I--Etude macroscopique des variations individuelles. II--Systématisation. Rev Neurol (Paris) 1977 Oct;133(10):533–545. [PubMed] [Google Scholar]
  13. Petit H., Rousseaux M., Clarisse J., Delafosse A. Troubles oculo-céphalomoteurs et infarctus thalamo-sous-thalamique bilatéral. Rev Neurol (Paris) 1981;137(11):709–722. [PubMed] [Google Scholar]
  14. Pierrot-Deseilligny C. H., Chain F., Gray F., Serdaru M., Escourolle R., Lhermitte F. Parinaud's syndrome: electro-oculographic and anatomical analyses of six vascular cases with deductions about vertical gaze organization in the premotor structures. Brain. 1982 Dec;105(Pt 4):667–696. doi: 10.1093/brain/105.4.667. [DOI] [PubMed] [Google Scholar]
  15. Rousseaux M., Petit H., Hache J. C., Devos P., Dubois F., Warot P. La motricité oculaire et céphalique dans les infarctus de la région thalamique. Rev Neurol (Paris) 1985;141(5):391–403. [PubMed] [Google Scholar]
  16. Squire L. R., Moore R. Y. Dorsal thalamic lesion in a noted case of human memory dysfunction. Ann Neurol. 1979 Dec;6(6):503–506. doi: 10.1002/ana.410060607. [DOI] [PubMed] [Google Scholar]
  17. Swanson R. A., Schmidley J. W. Amnestic syndrome and vertical gaze palsy: early detection of bilateral thalamic infarction by CT and NMR. Stroke. 1985 Sep-Oct;16(5):823–827. doi: 10.1161/01.str.16.5.823. [DOI] [PubMed] [Google Scholar]
  18. Wall M., Slamovits T. L., Weisberg L. A., Trufant S. A. Vertical gaze ophthalmoplegia from infarction in the area of the posterior thalamo-subthalamic paramedian artery. Stroke. 1986 May-Jun;17(3):546–555. doi: 10.1161/01.str.17.3.546. [DOI] [PubMed] [Google Scholar]
  19. Winocur G., Oxbury S., Roberts R., Agnetti V., Davis C. Amnesia in a patient with bilateral lesions to the thalamus. Neuropsychologia. 1984;22(2):123–143. doi: 10.1016/0028-3932(84)90056-3. [DOI] [PubMed] [Google Scholar]
  20. von Cramon D. Y., Hebel N., Schuri U. A contribution to the anatomical basis of thalamic amnesia. Brain. 1985 Dec;108(Pt 4):993–1008. doi: 10.1093/brain/108.4.993. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES