Neurológia pre prax 6/2008

BILATERAL PARAMEDIAN THALAMIC INFARCTION AS A RARE CAUSE OF CONSCIOUSNESS DISTURBANCE

Paramedian thalamic infarctions (particularly the relatively frequently occurring bilateral ones) represent a very remarkable clinical entity. Bilateral paramedian thalamic infarction was described for the first time by Schuster more than 70 years ago, presenting with a classical triad of consciousness disturbances, vertical gaze, and amnesic syndrome. Despite a long period of time and a number of publications since, there is still little awareness among clinicians and differential diagnosis in the case of acute consciousness disturbances is difficult. We report a case of a patient with bilateral paramedian thalamic infarction and discuss the mechanism of origin of clinical symptomatology.

Keywords: cerebral infarction, thalamus, consciousness disturbances.