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On neurological examination, she showed disorientation to time and place and incoherent speech. Relatives reported memory loss in recent months. Lab results and lumbar puncture were normal, and a cranial computed tomography scan ruled out any acute pathology. Upon suspicion of an onset of dementia, a magnetic resonance imaging (MRI) was requested in order to identify the origin. In the FLAIR sequences (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) hypointense punctiform images were identified in both sides of the thalamus with peripheral hypersignal attributable to astrocytosis (arrows), compatible with lacunar infarcts. Decreased signal intensity foci were observed in the gradient-echo sequences (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) due to the presence of hemosiderin deposits (arrows). The findings described above were suggestive of strategic infarcts of the thalamus.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Bilateral thalamic infarctions are considered strategic infarcts because they affect areas of the brain that are crucial for cognitive functioning. Dysfunction in thalamus-prefrontal cortex circuits can produce vascular dementia, known as “thalamic dementia”, which only accounts for 4.6% of vascular dementia cases. Clinically, they can produce complex neuropsychological symptoms, such as disorientation to time and place, speech impairment or memory loss.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interests" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López Banet E, Páez Granda D, Orcajada Zamora V, Vázquez Sáez V. Infartos estratégicos del tálamo: una causa infrecuente de demencia vascular. Med Clin (Barc). 2018;150:249.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1320 "Ancho" => 1000 "Tamanyo" => 125209 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1347 "Ancho" => 1000 "Tamanyo" => 108256 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015000000006/v1_201803290432/S2387020618300238/v1_201803290432/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015000000006/v1_201803290432/S2387020618300238/v1_201803290432/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618300238?idApp=UINPBA00004N" ]
Journal Information
Vol. 150. Issue 6.
Pages 249 (March 2018)
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Vol. 150. Issue 6.
Pages 249 (March 2018)
Image in medicine
Strategic infarcts of the thalamus: An uncommon cause of vascular dementia
Infartos estratégicos del tálamo: una causa infrecuente de demencia vascular
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Elena López Banet
, Diego Páez Granda, Víctor Orcajada Zamora, Victoria Vázquez Sáez
Corresponding author
Servicio de Neurorradiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
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