Neuro-ophthalmologic Manifestations of Thalamic Stroke

Abstract

In a patient with a deficit of ocular movement that goes beyond any anatomically specific pattern one must always bear in mind the role of thalamic nuclei in ocular motor function. We present three case reports depicting manifestations of infarction in the vascular territories of arteries that supply thalamus. The first case presented with a complete, ipsiversive ocular tilt reaction and the second case presented with Parinaud’s syndrome as a result of a paramedian thalamic infarction extending into the rostral midbrain. The third one presented as a left eye ptosis with Korsakoff-like amnestic syndrome due to anteromedian thalamic infarction, which can be a result of both tuberothalamic and paramedian artery infarction. An unusual presentation of ocular movement disorders without an unequivocal anatomical correlation or an ocular movement disorder coupled with an amnestic syndrome should raise suspicion for possible infarction in one of the thalamic arteries.

Keywords::

• Korsakoff amnestic syndrome
• ocular tilt reaction
• paramedian artery
• Parinaud’s syndrome
• ptosis
• thalamus
• tuberothalamic artery

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Note: To view ‘Video 1’ mentioned in this article, please access this article online at www.informahealthcare. com/oph and view ‘Supplemental material’.