THALAMIC VASCULAR-LESIONS - RISK-FACTORS AND CLINICAL COURSE FOR INFARCTS AND HEMORRHAGES

Background and Purpose The data of patients with an MRI-confirmed diag nosis of thalamic stroke were analyzed to identify risk factors and to describe the clinical syndromes according to the thalamic arterial te rritory involved. Methods We examined the records of all patients with a diagnosis of thalamic stroke confirmed by MRI who attended the Nati onal Institute of Neurology and Neurosurgery ''Manuel Velasco Suarez'' from 1987 through 1995. A database containing demographic features, r isk factors, clinical course, type and mechanism of stroke, and vascul ar territory was analyzed. Results Twenty-eight patients (19 men and 9 women; mean age, 48.2 years) had MRI-confirmed thalamic stroke. Infar ct was present in 22 patients and hemorrhage in 6. Eleven (39.3%) pati ents were younger than 45 years. In these young patients, cigarette sm oking was the main risk factor associated with the development of stro ke. In young patients, isolated and multiple thalamic lesions were pre sent in almost equal proportions. The remaining 17 patients were older adults (45 to 84 years of age). In such patients, most lesions were m ultiple and were associated with atherosclerosis-predisposing factors. The main distinguishing clinical feature for hemorrhages and paramedi an infarcts in comparison with infarcts in the other thalamic territor ies was the presence of an altered level of consciousness. No patient died as a direct result of the stroke. Conclusions Thalamic stroke com monly occurs in young adults, and its mechanism is often undetermined. Increased awareness of this type of stroke in young adults should lea d to better delineation of its clinical features, course, and manageme nt.