Paramedian Thalamic Infarction Following Blunt Head Injury —Case Report—

Toshihiko KUROIWA; Harushi TANABE; Hiroyuki TAKATSUKA; Motohiro ARAI; Takashi OZAKI; Shiro NAGASAWA; Tomio OHTA

doi:10.2176/nmc.34.20

Toshihiko KUROIWA, Harushi TANABE, Hiroyuki TAKATSUKA, Motohiro ARAI, Takashi OZAKI, Shiro NAGASAWA, Tomio OHTA

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Keywords: head injury, paramedian thalamic infarction, computed tomography, magnetic resonance imaging

JOURNAL FREE ACCESS

1994 Volume 34 Issue 1 Pages 20-22

DOI https://doi.org/10.2176/nmc.34.20

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Abstract

A 19-year-old male was admitted following a blow to the face. Computed tomographic (CT) scans 1 hour after injury revealed low-density areas in the bilateral thalami and midbrain, which were enhanced postcontrast except for the core 3 hours later. CT scans 2 days after injury revealed that the size of the low-density areas had increased. CT scans and magnetic resonance images 3 weeks after injury disclosed only small infarcted lesions in the bilateral thalami, the right side of the midbrain, and the left internal capsule. These findings suggest that the injury initially caused thrombus on the basilar arterial wall, leading to occlusion of the perforators, but almost all affected perforators were recanalized. Bilateral thalamic infarction resulting from head injury is unusual, as is the transient nature of the infarction in this case.

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