Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-28T11:00:33.269Z Has data issue: false hasContentIssue false

Thalamic Stroke: Precursors and Outcomes for Ten Patients

Published online by Cambridge University Press:  06 May 2014

Johanna Freeland
Affiliation:
School of Psychology, University of Newcastle, NSW, Australia
Christopher Levi
Affiliation:
Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia Centre for Translational Neuroscience and Mental Health, Hunter Medical Research Institute, NSW, Australia
Mick Hunter*
Affiliation:
School of Psychology, University of Newcastle, NSW, Australia Centre for Translational Neuroscience and Mental Health, Hunter Medical Research Institute, NSW, Australia
*
Address for correspondence: Conjoint Associate Professor Mick Hunter, School of Psychology, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. E-mail: mick.hunter@newcastle.edu.au
Get access

Abstract

Objective: The purpose of this study was to examine susceptibility factors in thalamic stroke, as well as outcomes in order to identify rehabilitation needs.

Methods: Ten patients with thalamic stroke were interviewed and administered the Audio Recorded Cognitive Screen. Magnetic resonance imaging (MRI) scans were examined to determine location and size of the lesion, as well as basilar artery size and anatomical variances in the circle of Willis.

Results: Risk factors such as high cholesterol, high blood pressure and pre-existing heart conditions were identified. Circle of Willis variations were found in 6 of the 10 participants, with MR angiography indicating that the posterior communication artery was absent or failed to join the posterior cerebral artery. Basilar artery diameter measurements were no larger than normal. All participants reported post-stroke changes, including decreased coordination and mobility, poor balance, reduced energy, memory deficits and mood changes. Participants’ overall scores on cognitive tests were significantly lower than age-matched norms. Performance on the test domains of memory, fluency, language and attention were all significantly below age norms.

Conclusions: The variability of outcome measures demonstrates the difficulty of defining patterns of relationship between risk factors and severity of functional sequelae in thalamic stroke.

Type
Articles
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alastruey, J., Parker, K.H., Peiro, J., Byrd, S.M., & Sherwin, S.J. (2007). Modelling the circle of Willis to assess the effects of anatomical variations and occlusions on cerebral flows. Journal of Biomechanics, 40 (8), 17941805.Google Scholar
Amici, S. (2012). Thalamic infarcts and hemorrhages. Frontiers of Neurology & Neuroscience, 30, 132136.CrossRefGoogle ScholarPubMed
Barraquer-Bordas, L., Illa, I., Escartin, A., Ruscalleda, J., & Marti-Vilalta, J.L. (1981). Thalamic hemorrhage. A study of 23 patients with diagnosis by computed tomography. Stroke, 12 (4), 524527.Google Scholar
Chui, C., & Howng, S.L. (1989). Thalamic hemorrhage: a computed tomographic-clinical study in prognostic prediction. Kaohsiung Journal of Medical Sciences, 5 (4), 231240.Google ScholarPubMed
Chung, C.S., Caplan, L.R., Han, W., Pessin, M.S., Lee, K.H., & Kim, J.M. (1996). Thalamic haemorrhage. Brain, 119 (Pt 6), 18731886.Google Scholar
Deng, D., Cheng, F.B., Zhang, Y., Zhou, H.W., Feng, Y., & Feng, J.C. (2012). Morphological analysis of the vertebral and basilar arteries in the Chinese population provides greater diagnostic accuracy of vertebrobasilar dolichoectasia and reveals gender differences. Surgical and Radiologic Anatomy, 34 (7), 645650.Google Scholar
De Silva, K.R., Silva, R., Amaratunga, D., Gunasekera, W.S., & Jayesekera, R.W. (2011). Types of the cerebral arterial circle (circle of Willis) in a Sri Lankan population. BMC Neurology, 11, 5.CrossRefGoogle Scholar
De Silva, K.R., Silva, R., Gunasekera, W.S., & Jayesekera, R.W. (1998). Prevalence of typical circle of Willis and the variation in the anterior communicating artery: A study of a Sri Lankan population. Annals of the Indian Academy of Neurology, 12, 157161.Google Scholar
El-Barhoun, E.N., Gledhill, S.R., & Pitman, A.G. (2009). Circle of Willis artery diameters on MR angiography: an Australian reference database. Journal of Medical Imaging and Radiation Oncology, 53 (3), 248260.Google Scholar
Fisher, C.M. (1959). The pathologic and clinical aspects of thalamic hemorrhage. Transactions of the American Neurological Association, 84, 5659.Google Scholar
Kapoor, K., Singh, B., & Dewan, L.I. (2008). Variations in the configuration of the circle of Willis. Anatomical Science International, 83 (2), 96106.Google Scholar
Karnath, H.-O., Johannsen, L.L., Broetz, D.D., & Kueker, W.W. (2005). Posterior thalamic hemorrhage induces ‘pusher syndrome’. Neurology, 64 (6), 10141019.Google Scholar
Kumral, E., Kocaer, T., Ertubey, N.O., & Kumral, K. (1995). Thalamic hemorrhage. A prospective study of 100 patients. Stroke, 26 (6), 964970.Google Scholar
Lechner-Scott, J., Kerr, T., Spencer, B., Agland, S., Lydon, A., & Schofield, P.W. (2010). The Audio Recorded Cognitive Screen (ARCS) in patients with multiple sclerosis: a practical tool for multiple sclerosis clinics. Multiple Sclerosis, 16, 11261133.Google Scholar
Li, Q., Li, J., Lv, F., Li, K., Luo, T., & Xie, P. (2011). A multidetector CT angiography study of variations in the circle of Willis in a Chinese population. Journal of Clinical Neuroscience, 18 (3), 379383.CrossRefGoogle ScholarPubMed
Loughland, C.M., Allen, J., Gianacas, L., Schofield, P.W., Lewin, T.J., Hunter, M., & Carr, V.J. (2010). Brief neuropsychological profiles in psychosis: a pilot study using the Audio Recorded Cognitive Screen (ARCS). Acta Neuropsychiatrica, 22, 243252.Google Scholar
Pico, F., Labreuche, J., Gourfinkel-An, I., & Amarenco, P. (2006). Basilar artery diameter and 5-year mortality in patients with stroke. Stroke, 37 (9), 23422347.CrossRefGoogle ScholarPubMed
Schmahmann, J.D. (2003). Vascular syndromes of the thalamus. Stroke, 34 (9), 22642278.Google Scholar
Schofield, P.W., Lechner-Scott, J., Loughland, C., & Moore, T. (2013). The Audio Recorded Cognitive Screen (ARCS): a flexible and versatile instrument for clinic and research. In Gauthier, M. (Ed.), Screening tests. Hauppauge, New York: Nova Science Publishers.Google Scholar
Schofield, P.W., Lee, S.J., Lewin, T.J., Lyall, G., Moyle, J., Attia, J., & McEvoy, M. (2010). The Audio Recorded Cognitive Screen (ARCS): a flexible hybrid cognitive test instrument. Journal of Neurology, Neurosurgery, & Psychiatry, 81,(6), 602607.Google Scholar
Schofield, P.W., Lee, S.J., Lyall, G., Zunong, R.N., & Kwan, E.Y. (2008). The ARCS: A hybrid cognitive test instrument, highly efficient for the clinician. Alzheimer's and Dementia, 4 (4), T571–T572.Google Scholar
Shah, S.D., Kalita, J., Misra, U.K., Mandal, S.K., & Srivastava, M. (2005). Prognostic predictors of thalamic hemorrhage. Journal of Clinical Neuroscience, 12 (5), 559561.CrossRefGoogle ScholarPubMed
Smoker, W.R., Price, M.J., Keyes, W.D., Corbett, J.J., & Gentry, L.R. (1986). High-resolution computed tomography of the basilar artery: 1. Normal size and position. American Journal of Neuroradiology, 7, 5560.Google ScholarPubMed
Song, Y.M. (2011). Topographic patterns of thalamic infarcts in association with stroke syndromes and aetiologies. Journal of Neurology, Neurosurgery, & Psychiatry, 82 (10), 10831086.Google Scholar
Summers, M.J. (2002). Neuropsychological consequences of right thalamic haemorrhage: Case study and review. Brain and Cognition, 50, 129138.Google Scholar
Tanaka, H., Fujita, N., Enoki, T., Matsumoto, K., Watanabe, Y., Murase, K., & Nakamura, H. (2006). Relationship between variations in the circle of Willis and flow rates in internal carotid and basilar arteries determined by means of magnetic resonance imaging with semiautomated lumen segmentation: Reference data from 125 healthy volunteers. American Journal of Neuroradiology, 27 (8), 17701775.Google Scholar