Anatomical Variations in the Posterior Part of the Circle of Willis and Vascular Pathology in Bilateral Thalamic Infarction. Issue 4 (26th April 2013)

• Record Type: Journal Article
• Authors: Förster, Alex; Nölte, Ingo; Wenz, Holger; Al‐Zghloul, Mansour; Kerl, Hans U.; Brockmann, Marc A.; Groden, Christoph
• Is Part Of: Journal of neuroimaging. Volume 24:Issue 4(2014)
• Page Start: 325
• Page End: 330
• Publication Date: 2013-04-26
• Subjects: Diagnostic imaging -- Periodicals; Nervous system -- Diseases -- Diagnosis -- Periodicals; Imagerie pour le diagnostic -- Périodiques; Système nerveux -- Maladies -- Diagnostic -- Périodiques; Imagerie médicale; Neuroimagerie; Neurologie; Système nerveux; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.804754
• DOI: 10.1111/jon.12022
• Languages: English
• ISSNs: 1051-2284

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="jon12022-sec-0010" sec-type="section"> <title>BACKGROUND AND PURPOSE</title> <p>Bilateral paramedian thalamic infarction is a rare subtype of stroke the etiology of which still remains undetermined in many patients.</p> </sec> <sec id="jon12022-sec-0020" sec-type="section"> <title>METHODS</title> <p>From a computed tomography (CT)/magnetic resonance imaging report database, we identified and analyzed 48 patients with bilateral paramedian thalamic infarction on diffusion‐weighted imaging. Vascular pathologies were noted on CT angiography (CTA)/magnetic resonance angiography (MRA) and the P1 segments of the posterior cerebral artery (PCA) described as normal, hypoplastic, or absent.</p> </sec> <sec id="jon12022-sec-0030" sec-type="section"> <title>RESULTS</title> <p>Vascular imaging revealed top of the basilar artery (BA) occlusion in 6 (12.5%), BA occlusion in 4 (8.3%), BA stenosis in 1 (2.1%), and BA hypoplasia in 3 (6.3%), PCA occlusion in 4 (8.3%), and PCA stenosis in 4 (8.3%) patients. In 18 (37.5%) patients, one or both P1 segments of the PCA were hypoplastic or absent. Patients with hypoplastic/absent P1 segments were more likely to have exclusively bilateral paramedian thalamic lesions (<italic>P</italic> < .001). An embolic source could be identified in 25 (55.6%) patients; there were no significant differences between both groups.</p> </sec> <sec id="jon12022-sec-0040" sec-type="section"> <title>CONCLUSIONS</title> <p>Vascular imaging is useful to determine underlying vascular pathologies and may support the diagnosis of small vessel disease in those patients with isolated bilateral paramedian thalamic infarction, hypoplastic/absent P1 segment of the PCA, and lack of vascular pathology.</p> </sec> </abstract>