• Revista de neurologia · Feb 2008

    Case Reports

    [Thalamic dementia secondary to acute bilateral paramedian thalamic infarcts after occlusion of the artery of Percheron].

    • N García-Casares, F J Garzón-Maldonado, and C de la Cruz-Cosme.
    • Servicio de Neurología, Hospital Clínico Universitario Virgen de Victoria, Málaga, España. nagcasares@gmail.com
    • Rev Neurol. 2008 Feb 16; 46 (4): 210-2.

    IntroductionThe anterior and medial part of the thalamus is the responsible of multiples cognitive functions through the thalamus-cortical connections. A bilateral thalamic infarction can cause a secondary dementia and these are related to a thalamocortical deafferentation with a partial recovery. We report a case of sudden onset dementia caused by bilateral thalamus lesions.Case ReportA 42 smoker male, that suddenly had an acute confusional syndrome with altered language, bradypsychia, right hemiparesis and right hemisensory loss. Cranial magnetic resonance imaging showed a bilateral thalamic stroke probably due to a variant talamus irrigation (artery of Percheron type 2). From this date, in three months, the patient had attention deficit, impairment of memory retention, apathy, initiative deficit, depressive syndrome and mood changes. All these symptoms improving partially in the following six months.ConclusionsThe thalamic stroke can cause a thalamic dementia, commonly bilateral and preferable located in the anterior and medial nuclei. In our case, cranial SPECT showed frontal hypocaptation for diaschisis phenomenon.

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