Bilateral thalamic lesions.

Department of Radiology and Radiological Sciences, Uniformed Services University, Bethesda, MD 20814, USA.
American Journal of Roentgenology (Impact Factor: 2.9). 03/2009; 192(2):W53-62. DOI: 10.2214/AJR.08.1585
Source: PubMed

ABSTRACT OBJECTIVE: The purpose of this study was to present the neuroimaging findings and differential diagnosis of bilateral thalamic lesions. CONCLUSION: The limited differential diagnosis of bilateral thalamic lesions can be further narrowed with knowledge of the specific imaging characteristics of the lesions in combination with the patient history.

1 Bookmark
  • [Show abstract] [Hide abstract]
    ABSTRACT: Toxic and metabolic disorders affecting the basal ganglia are variable, common, and easily misinterpreted on neuroimaging studies. Integration of clinical information with imaging findings is key to helping referring physicians diagnose and treat the underlying ailment. This review aims to provide a systematic approach to both computed tomography and magnetic resonance imaging findings, their potential causes, and their clinical implications.
    Seminars in ultrasound, CT, and MR. 04/2014; 35(2):75-84.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Artery of Percheron is a rare vascular variant in which a single dominant thalamoperforating artery arises from one P1 segment and bifurcates to supply both paramedian thalami. Occlusion of this uncommon vessel results in a characteristic pattern of bilateral paramedian thalamic infarcts with or without mesencephalic infarctions. We report a case of a 31-year-old man with acute bilateral thalamic infarcts and a truncated Artery of Percheron demonstrated on magnetic resonance angiography (MRA). Occlusion of the vessel was presumably due to embolism from a patent foramen ovale that was subsequently closed. The case presentation is followed by a discussion of bilateral paramedian thalamic infarcts including the causes and clinical presentation. The differential diagnosis of vascular and nonvascular etiologies of bilateral thalamic lesions is also discussed.
    Journal of Radiology Case Reports 01/2013; 7(7):7-14.
  • [Show abstract] [Hide abstract]
    ABSTRACT: While there are broad differential diagnoses for either the clinical finding of hemichorea-hemiballism or the imaging finding of lateralizing/asymmetric basal ganglia lesions (hyperdense on computed tomography, hyperintense on T1 magnetic resonance imaging), the presence of both findings is highly suggestive of nonketotic hyperglycemia. We present an unusual case of a patient with vague stroke-like complaints and imaging findings notable for lateralizing basal ganglia lesions. Laboratory analysis revealed nonketotic hyperglycemia and neurologic exam failed to elicit any findings of movement disorder. As far as we know, this is the first published case of a patient with typical neuroimaging manifestations of nonketotic hyperglycemia without associated hemichorea-hemiballism (a disorder of abnormal movements comprised of more proximal, higher amplitude movements-ballismus and lower amplitude, more distal movements-chorea). This finding suggests that radiologists should be alert to the possibility of nonketotic hyperglycemia in patients with asymmetric/lateralizing basal ganglia lesions even in the absence of a movement disorder.
    Journal of Radiology Case Reports 01/2013; 7(8):1-9.