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Images in Neurology
November 2006

Bilateral Paramedian Thalamic Infarcts

Arch Neurol. 2006;63(11):1652. doi:10.1001/archneur.63.11.1652

A 60-year-old man with hypertension and dyslipidemia had a sudden onset of somnolence and gait ataxia. The neurological examination revealed skew deviation, bilateral dysmetria, and bilateral extensor plantar responses. Fluctuation in consciousness was noted for several weeks, but the patient gradually recovered. The neuroimaging studies demonstrated symmetric bilateral hyperintense thalamic lesions on T2-weighted images consistent with ischemic events (Figure 1). Basilar arteries and posterior cerebral arteries (PCAs) were fully patent on magnetic resonance angiography (not shown).

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