Bilateral Thalamic Infarct in Two Unresponsive Octogenarians
Luca Masotti *
Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy and Internal Medicine, Cecina Hospital, Cecina, Italy
Gianni Lorenzini
Internal Medicine, Cecina Hospital, Cecina, Italy
Francesca Gallesi
Department of Radiology, Cecina Hospital, Cecina, Italy
Daniel Agustin Godoy
Neurointensive Care Unit, Sanatorio Pasteur, Catamarca, Argentina
Mario Di Napoli
Neurological Service, San Camillo de’ Lellis General Hospital, Rieti, Italy
*Author to whom correspondence should be addressed.
Abstract
Bilateral thalamic infarct (BTI) represents an uncommon stroke presentation. Pathophysiology recognizes the occlusion of an anatomic variant of the thalamic blood supply from perforating branches of posterior cerebral arteries. Presentation could be nonspecific and dramatic in the same time, being coma or stupor the possible clinical scenario encountered. Diagnosis is performed by neuroradiological imaging showing the typical bilateral paramedian thalamic infarcts. Literature lacks of evidence in very old patients, therefore we describe two cases of BTI occurred in octogenarians presenting unresponsive. BTI in very old patients presenting comatose should be taken in account as diagnostic possibility.
Keywords: Percheron syndrome, bilateral talamic infarct, stroke, elderly