Sekar, D (2014) Clinico-Radiological correlation in Thalamic Vascular Syndromes. Masters thesis, Madras Medical College, Chennai.
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Abstract
Stroke is a major cause of death and disability worldwide and the second most common cause of death. It is a common cause of dependency among all the neurological disorders. 1,2 . According to World Health Organization (WHO) stroke is defined as rapidly developing clinical symptoms and / or signs of focal, at times global loss of cerebral function, with symptoms lasting more than 24 hours or leading to death, with no apparent cause other than of vascular origin. The global prevalence of stroke is 5 to 8 /1000. Globally stroke incidence varies according to the ethnic differences in a common geographical location and ranged from 93 to 223/1,00,000 population. The incidence of stroke in India is difficult to study due to multiple factors. The stroke risk increases steadily as the age advances. The term stroke is applied to a sudden focal neurologic syndrome,1 caused by cerebrovascular disease. The vascular pathologic process may be considered not only in its grosser aspects-embolism, thrombosis, dissection, or rupture of a vessel-but also in terms of more basic or primary disorder, i.e., atherosclerosis, hypertensive arteriosclerotic change, arteritis, aneurysmal dilatation, and developmental malformation. Most strokes are sudden onset of a focal neurologic deficit .Stroke is the one, which is common among many neurological disorders. Worldwide, stroke is one of the leading causes of death and a major etiology for adult disability. Stroke poses serious problems with medical, rehabilitation and socioeconomic status. As the prevalence of disability due to stroke is expected to rise due to increase in population, this burden will still increase over the next few decades. Thalamus can also be affected as infarct or haemorrhagic stroke. Thalamic stroke can occur in isolation or in combination with other areas of involvement. isolated involvement of thalamus is not very common compared to other areas. Unlike other regions, thalamus has got different regions and multiple different nuclei and connected to different areas of brain through extensive connections with afferent and efferent fibres. It has got different blood supply. Hence , thalamus subserves different functions ranging from touch sensation to maintaining arousal state. Hence a thalamic lesion can have different and varied manifestations ranging from a common and classical hemisensory loss or hemiparesis and may cause comatose state. The risk factors for thalamic vascular syndromes are similar to other areas of stroke. As like other areas of stroke the incidence of thalamic stroke increases in old age. CONCLUSION : 1) This study shows male preponderance in the acute thalamic stroke. 2) In this study commonest age group affected is >60 years (53.5%) followed by 40 to 60 years (43%followed by <40 years (3.3%). 3) In this study there is predominance of thalamic infarction(70%) over haemorrhage(30%). 4) In this study, most common risk factors seen are smoking (49%), hytertension &dyslipidemia (40%) , Diabetes Mellitus (23%) Coronary Heart Disease (20%) & Atrial Fibrilation (3 %). 5) Rare risk factors like vasculitis and migraine are not seen. 6) Only one patient had cardioembolic stroke due to non valvular Atrial Fibrilation. 7) The commonest territory involved is thalamogeniculate in thalamic infarcts. 8) The commonest clinical presentation is hemisensory loss due to involvement of thalamogeniculate territory. 9) The commonest territory involved is posterolateral in thalamic Haemorrhage. 10) The commonest presentation in posterolateral haemorrhage is hemisensory loss and hemiparesis. 11) Posterior choroidal territory is least commonly affected in thalamic infarct. 12) Dorsal area is least commonly affected in thalamic haemorrhage. commonest area seen in altered sensorium is paramedian area.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Clinico-Radiological correlation ; Thalamic Vascular Syndromes. |
| Subjects: | MEDICAL > Neurology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 30 Jun 2017 02:42 |
| Last Modified: | 30 Jun 2017 05:47 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/672 |
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