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Thalamic strokes that severely impair arousal extend into the brainstem
Journal article   Peer reviewed

Thalamic strokes that severely impair arousal extend into the brainstem

Joseph Hindman, Mark D Bowren, Joel Bruss, Brad Wright, Joel C Geerling and Aaron D Boes
Annals of neurology, Vol.84(6), pp.926-930
12/2018
DOI: 10.1002/ana.25377
PMCID: PMC6344294
PMID: 30421457
url
https://www.ncbi.nlm.nih.gov/pmc/articles/6344294View
Open Access

Abstract

In this study, we evaluate the role of the thalamus in the neural circuitry of arousal. Level of consciousness within the first 12 hours of a thalamic stroke is assessed with lesion symptom mapping. Impaired arousal correlates with lesions in the paramedian posterior thalamus near the centromedian and parafascicular nuclei, posterior hypothalamus, and midbrain tegmentum. All patients with severely impaired arousal (coma, stupor) had lesion extension into the midbrain and/or pontine tegmentum, whereas purely thalamic lesions did not severely impair arousal. These results are consistent with growing evidence that pathways most critical for human arousal lie outside the thalamus. Ann Neurol 2018;84:926-930.
Magnetic Resonance Imaging Stroke - diagnostic imaging Thalamus - diagnostic imaging Humans Stupor - etiology Stroke - complications Male Thalamus - pathology Stroke - pathology Arousal - physiology Stupor - diagnostic imaging Time Factors Brain Stem - pathology Brain Mapping Coma - diagnostic imaging Female Retrospective Studies Imaging, Three-Dimensional Coma - etiology

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