Department of Neurology, Medical University of Lublin, 8 Jaczewskiego St., 20-954 Lublin, Poland.
Neurol Neurochir Pol. 2012 May-Jun;46(3):279-83. doi: 10.5114/ninp.2012.29135.
Unilateral thalamic lesions cause transient or permanent behavioral, sensory and oculomotor disturbances; bilateral lesions of thalamus result in more severe and longer lasting symptoms. We present an atypical case of bilateral paramedian thalamic infarct with concomitant hypothalamic dysfunction. The only risk factor of ischaemic stroke found in the patient was a short lasting episode of atrial fibrillation. Bilateral paramedian thalamic infarcts may result from occlusion of one paramedian thalamic artery, which arises from the posterior cerebral artery, either with separated or with a common trunk, thus supplying the thalamus bilaterally. Independently of anatomical variants of thalamus blood supply, the most probable cause of infarct in our patient was unilateral or bilateral occlusion of the posterior cerebral artery by cardioembolism, probably in the course of basilar artery occlusion. Hypothalamic dysfunction may accompany thalamic infarcts; thus hypothalamo-pituitary function should be routinely assessed in bithalamic infarcts.
单侧丘脑病变可引起短暂或永久性的行为、感觉和眼球运动障碍；双侧丘脑病变则导致更严重和持久的症状。我们报告了一例非典型的双侧丘脑旁正中梗死伴下丘脑功能障碍。患者唯一的缺血性脑卒中危险因素是短暂的心房颤动发作。双侧丘脑旁正中梗死可能是由发自大脑后动脉的单一或共干的丘脑旁正中动脉闭塞引起，从而双侧供应丘脑。独立于丘脑血供的解剖变异，我们患者梗死的最可能原因是心源性栓子单侧或双侧闭塞大脑后动脉，可能在基底动脉闭塞过程中发生。下丘脑功能障碍可伴随丘脑梗死；因此，在双侧丘脑梗死中应常规评估下丘脑-垂体功能。
