Clinical Manifestation of Thalamogeniculate Artery Territory Infarction

ABSTRACT

BACKGROUND: In terms of localizing value, the clinical features of small lesion confined to thalamus are of great interest. The clinical manifestations frequently comprise hemiparesis, hemianesthesia, and neuropsychological abnormalities and the main cause of thalamic infarct is thought to be an arteriolopathy. To better understand the relationship between the location of thalamic lesion and clinical features, we studied the charateristics of patients with thalamogeniculate artery(TGA) territory infarction, which is most common site of thalamic infarction. METHODS: We reviewed 732 ischemic stroke patient registered to our stroke database over 4-year period. On the basis of MRI, we identified 33 cases of small thalamic infarction(<2cm). Among them, 21 cases had a lesion purely confined to TGA territory. RESULTS: The clinical type of manifestations were sensorimotor(10), pure sensory(7), hemiataxia+sensory(2), hemiataxia+ sensorimotor(1) and involunatry movement(1), respectively. No cases had neuropsychological abnormalities. Only 19% of total cases developed classical Dejerine-Roussy syndrome on short term follow-up. Most patients had hypertension and/or diabetes with the absence of large vessel abnormalities on MRA, but none had the cardioembolic source. CONCLUSION: The lesion sizes of pure sensory thalamic infarction were relatively small. The classical Dejerine-Roussy syndrome had been originally described as the effect of TGA occlusion but uncommon in our series.