2021, 3(1):30-32 e-ISSN: 2674-7103

DOI: 10.37085/jmmv3.n1.2021.pp.30-32

Jornal Memorial

Medicina

Case Report

Lacunar lesion of the thalamus: a case report

Lesão lacuna no tálamo: relato de caso

Nataly Regina Fonseca Carvalho de Medeiros

Marcelo Andrade Valença

Elayne Cristina de Oliveira

Ribeiro

Ana Carolina Barreira Roso

Ana Rita de Oliveira Souza da Silva

Mateus Marinho Silva

de Souza¹ Talita Gabriele de Queiroz Plácido³ Leandro Ferreira de Sá

José Gabriel da Silva

Fernanda Biatriz Silva Costa

Arthur Alves Rodrigues Alencar

Taianara Sampaio

Maiza de

Oliveira Tenório

Larissa de Oliveira Beltrão

Débora Aline Oliveira Portela de Carvalho

, Danielle

Almeida Santos Paes Ferreira Marcelo Moraes Valença

Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.

Hospital da Restauração, Recife, Pernambuco, Brazil.

³Uninassau, Recife, Pernambuco, Brazil

Universidade Federal de Pernambuco, Campus Acadêmico do Agreste, Caruaru, Pernambuco, Brazil

Faculdade Pernambucana de Saúde – Instituto Materno Infantil de Pernambuco, Recife, Pernambuco, Brazil

Unifacisa, Campina Grande, Paraíba, Brazil

Universidade Católica de Pernambuco, Recife, Pernambuco, Brazil.

Abstract

In this article, the authors present a computed tomography (CT) image scan of the brain of a

72-year-old patient who, upon waking, noticed numbness in the left hemiface, hemithronchus, and

upper limb. Sensorimotor syndromes are commonly related to vascular infarction of inferolateral

artery (ILA) territory, also known as thalamogeniculate pedicle. Usually this pain disturbance

happens in right thalamic infarcts having a delayed onset, however, it might be acutely present-

ed.

Resumo

Neste artigo, os autores apresentam uma tomograa computadorizada (TC) do cérebro de um

paciente de 72 anos que, ao acordar, notou dormência na hemiface esquerda, hemitronco e

membro superior. As síndromes sensório-motoras são comumente relacionadas ao território do

infarto vascular da artéria inferolateral (ILA), também conhecido como pedículo talamogeniculado.

Normalmente, esse distúrbio de dor ocorre em infartos talâmicos direitos, tendo um início tardio,

no entanto, pode ser apresentado de forma aguda.

Nataly Regina Fonseca Carvalho

de Medeiros

natalyreg@gmail.com

Edited by

Juliana Ramos Andrade

Keywords:

Stroke

Lacunar

Thalamus

Diagnostic

Imaging

Palavras-chave:

Acidente Vascular Cerebral La-

cunar

Doenças Talâmicas

Diagnóstico por Imagem

Received: June 11, 2021

Accepted: June 17, 2021

ASAA

Medeiros RFC, Valença MA, Ribeiro ECO, Roso CB, Silva AROS, Souza MMS, Plácido TGQ, Sá LF, Silva JG, Costa FBS, Alencar AAR, Sampaio T, Tenório

MO, Beltrão LO, Carvalho DAOP, Ferreira DASP, Valença MM

Lacunar lesion of the thalamus: a case report

Introduction

he vascular supply of the thalamus's nuclei is composed

of four arteries (

i.e.

, tuberothalamic, inferolateral, para-

median, and posterior choroidal vessels). These arteries can

receive different anatomic names.

The arteries branches and

their tributaries may individually vary in number and location.

When small subcortical lesions within 15 mm are occluded by

a penetrating artery from a large cerebral artery, we may call

it as lacunar infarctions. Those may cause lacunar syndromes.

In this article, the authors present a computed tomography

(CT) image scan of the brain of a patient with a lacunar

lesion of the thalamus.

Case report

A 72-year-old woman presented, upon waking numbness in

the left hemiface, hemitrunk, and upper limb. On physical

examination, tactile hypoesthesia was detected in the left

hemibody with mild left central facial paralysis. CT shows

a lacunar lesion in the right ventroposterolateral thalamus

(Figure 1).

Comment

Sensorimotor syndromes are commonly related to vas-

cular infarction of inferolateral artery (ILA) territory, also

known as thalamogeniculate pedicle (Figure 2). This artery

emerges from the P2 segment of the Posterior Cerebral Ar-

tery (PCA). The principal inferolateral branches of ILA vas-

cular territory respond to the supply of the ventral posterior

thalamic nucleus complex.

This infarction area can be re-

lated to all modalities of sensorial loss with variable extent

besides motor decits, as presented in this case. The tha-

lamic syndrome can also be followed by central poststroke

pain, which is presented in 80% of cases.

Usually, this

pain disturbance happens in right thalamic infarcts having

a delayed onset, however, it might be acutely presented.

Figure 1. Computed tomography (CT). Small infero-

lateral artery territory infarction in the right thalamus

(arrows), presented as a lacunar hypodense spot. It

corresponds to the ventral posterior thalamic nuclei

complex.

Figure 2. Schematic image of thalamus irrigation.

ASAA

Medeiros RFC, Valença MA, Ribeiro ECO, Roso CB, Silva AROS, Souza MMS, Plácido TGQ, Sá LF, Silva JG, Costa FBS, Alencar AAR, Sampaio T, Tenório

MO, Beltrão LO, Carvalho DAOP, Ferreira DASP, Valença MM

Lacunar lesion of the thalamus: a case report

Nataly Regina Fonseca Carvalho de Medeiros

https://orcid.org/0000-0003-4415-395X

Marcelo Andrade Valença

https://orcid.org/0000-0002-0824-0928

Elayne Cristina de Oliveira Ribeiro

https://orcid.org/0000-0002-5243-3356

Ana Carolina Barreira Roso

https://orcid.org/0000-0001-7835-8270

Ana Rita de Oliveira Souza da Silva

https://orcid.org/0000-0002-9055-8790

Mateus Marinho Silva de Souza

https://orcid.org/0000-0003-1558-8524

Talita Gabriele de Queiroz Plácido

https://orcid.org/0000-0003-3860-6561

Leandro Ferreira de Sá

https://orcid.org/0000-0001-5391-7304

José Gabriel da Silva

https://orcid.org/

Fernanda Biatriz Silva Costa

https://orcid.org/0000-0002-3061-0737

Arthur Alves Rodrigues Alencar

https://orcid.org/0000-0002-6204-4530

Taianara Sampaio

https://orcid.org/0000-0002-7419-2485

Maiza de Oliveira Tenório

http://orcid.org/0000-0002-0968-0423

Larissa de Oliveira Beltrão

https://orcid.org/0000-0001-9341-1914

Danielle Almeida Santos Paes Ferreira

https://orcid.org/0000-0001-6357-531X

Marcelo Moraes Valença

https://orcid.org/0000-0003-0678-3782

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