Department of Neurology, Dankook University Hospital, 16-5, Anseo-Dong, Cheonan, Chungnam 330-715, South Korea.
J Neurol Neurosurg Psychiatry. 2011 Oct;82(10):1083-6. doi: 10.1136/jnnp.2010.239624. Epub 2011 Mar 15.
To characterise the topographic patterns of thalamic infarcts associated with various stroke syndromes and aetiologies.
In this study, 168 consecutive patients with acute infarcts involving the thalamus were investigated by use of diffusion weighted MR imaging. Involved thalamic territories were classified into four vascular territories: anterior (polar artery), posteromedial (thalamoperforating artery), ventrolateral (thalamogeniculate artery) and posterolateral (posterior choroidal artery) territory. The distribution of thalamic infarcts involving specific vascular territories in association with various stroke syndromes and aetiologies were analysed.
There was a significant association between involvement of the ventrolateral thalamus and isolated thalamic infarcts (49 patients (73%), p<0.01) or posterior cerebral artery infarcts (29 patients (76%), p=0.02), and between involvement of the posteromedial thalamus and top of the basilar artery syndrome (17 patients (77%), p<0.001) or extended posterior circulation infarcts (29 patients (71%), p<0.001). The ventrolateral territory was most commonly affected in association with small vessel disease (43 patients (72%), p=0.03) and the posteromedial territory in association with large artery disease (19 patients (63%), p<0.01). In cardioembolic stroke, the ventrolateral, posteromedial and posterolateral territories were equally affected.
The results of the present study indicate a specific association between the topographic patterns of thalamic infarcts and the stroke syndromes and aetiologies.
描述与各种中风综合征和病因相关的丘脑梗死的地形模式。
本研究使用弥散加权磁共振成像对 168 例急性丘脑梗死患者进行了研究。受累丘脑区域分为四个血管区域：前（极动脉）、后内侧（丘脑穿通动脉）、外侧（丘脑纹状体动脉）和后外侧（后脉络膜动脉）区域。分析了特定血管区域受累与各种中风综合征和病因相关的丘脑梗死的分布。
外侧丘脑受累与孤立性丘脑梗死（49 例（73%），p<0.01）或大脑后动脉梗死（29 例（76%），p=0.02）之间存在显著关联，后内侧丘脑受累与基底动脉顶端综合征（17 例（77%），p<0.001）或扩展后的循环梗死（29 例（71%），p<0.001）之间存在显著关联。外侧区域最常与小血管疾病（43 例（72%），p=0.03）相关，后内侧区域最常与大动脉疾病（19 例（63%），p<0.01）相关。在心源性栓塞性中风中，外侧、后内侧和后外侧区域同样受累。
本研究结果表明，丘脑梗死的地形模式与中风综合征和病因之间存在特定的关联。
