Bilateral Thalamic Ischemic Injury : A case report .

, Kim, Sang Hyun; , Seok, Hyun; , Lee, Jang Bok; , Suh, Jung Woo

Case Report

Journal of the Korean Academy of Rehabilitation Medicine 2009;33(2):242-245.

Kim, Sang Hyun , Seok, Hyun , Lee, Jang Bok , Suh, Jung Woo

Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University, Korea. bregmavo@gmail.com

양측성 시상 허혈 손상 1례-증례 보고-

김상현,석현,이장복,서정우

순천향대학교 의과대학 재활의학교실

Abstract

Thalamic infarction is frequently bilateral due to the nature of the vascular supply to the thalamic region, and is usually caused by cardiogenic embolism or emboli originating from the proximal basilar or vertebral artery. But there have been no reported case of bilateral thalamic ischemic injury. A 25-year old man was in coma after committing suicide, hanging his neck. MRI showed bilateral pulvinar ischemic injury. He showed disturbance in recent memory, cal-cula-tion, and had bilateral hemianopsia, transcortical motor ap-hasia, intentional tremor, proprioceptive sensory dysfunction. He was treated with progressive physical therapy for ambulation, repeated stimuli with TENS for proprioception, given donepezil 5 mg and cognitive training for improve-ment of cognition. After discharge, he was able to walk independently at outdoors, and could do all activities of daily living by himself. All motor and sensory functions of upper and lower extremities were recovered except tremor and dynamic standing balance dysfunction. (J Korean Acad Rehab Med 2009; 33: 242-245)

Key Words: Bilateral thalamic ischemic injury