Dobato J L, Villanueva J A, Giménez-Roldán S
Department of Neurology, Hospital General Gregorio Marañón, Madrid, Spain.
Stroke. 1990 Dec;21(12):1749-53. doi: 10.1161/01.str.21.12.1749.
Ataxic hemiparesis with cerebellar-like features has been reported following infarction or hemorrhage of the thalamus. We describe five patients with incoordination and corticospinal tract signs in the limbs opposite a dorsolateral thalamic hemorrhage. In four patients the hemorrhage extended superiorly into the lateral ventricle, the adjacent paraventricular region, and the upper and medial parts of the posterior limb of the internal capsule. Instead of cerebellar dysfunction, these patients exhibited directional errors of movement that improved distinctly when performed under visual guidance. We explain the incoordination on the basis of conscious deep sensory loss in the involved limbs. Perception of light touch, painful pinprick, and temperature were preserved in all patients. We use the term "sensory ataxic hemiparesis" to distinguish these patients from those with "classic" ataxic hemiparesis and cerebellar-like features, a distinction that may be important when planning functional rehabilitation.
丘脑梗死或出血后曾有报道出现具有小脑样特征的共济失调性偏瘫。我们描述了5例在背外侧丘脑出血对侧肢体出现不协调及皮质脊髓束体征的患者。4例患者的出血向上延伸至侧脑室、邻近的室周区域以及内囊后肢的上部和内侧部分。这些患者并未表现出小脑功能障碍，而是出现了运动方向错误，在视觉引导下进行时明显改善。我们基于受累肢体存在意识性深感觉丧失来解释这种不协调。所有患者的轻触觉、痛觉针刺及温度觉均保留。我们使用“感觉性共济失调性偏瘫”这一术语将这些患者与具有“经典”共济失调性偏瘫及小脑样特征的患者区分开来，这一区分在规划功能康复时可能很重要。
