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Case Reports
. 2021 May 10;13(5):e14935.
doi: 10.7759/cureus.14935.

Bilateral Thalamic Stroke as a Cause of Decreased Responsiveness

Mansoor Qureshi  1 , Marvi Qureshi  2   3 , Muhammad Gul  4 , David Lebowitz  5   3 , Latha Ganti  6   5   3   2
Affiliations
Case Reports

Bilateral Thalamic Stroke as a Cause of Decreased Responsiveness

Mansoor Qureshi et al. Cureus. .

Abstract

We report the case of a 77-year-old male with no prior history of stroke who came in as a stroke alert for right facial droop and speech slurring, but upon presentation he had decreased responsiveness. Initial imaging for stroke was negative. Laboratory evaluation revealed no abnormalities. As lumbar puncture was about to be performed, the patient had a sudden resolution of symptoms, became responsive, and started answering questions. Magnetic resonance imaging (MRI) revealed small acute infarcts in the bilateral thalami and adjacent central aspect of the midbrain, right larger than the left. General decreased responsiveness needs to be considered in the differential diagnosis of stroke.

Keywords: acute stroke; cerebrovascular disease; emergency department; ischemic stroke; thalamic infarct.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Initial “stroke alert” CT, which did not reveal any evidence of hemorrhage or infarct.
CT, computed tomography
Figure 2
Figure 2. MRI demonstrating right greater than left bilateral thalamic infarcts (yellow arrows). The left panel is the axial T2 FLAIR image, the center panel shows the infarct on sagittal view (red arrow), and the right panel is the ADC image.
MRI, magnetic resonance imaging; FLAIR, fluid-attenuated image recovery; ADC, apparent diffusion coefficient
See this image and copyright information in PMC

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