dc.contributor.author
Fritsch, Merve
dc.contributor.author
Villringer, Kersten
dc.contributor.author
Ganeshan, Ramanan
dc.contributor.author
Rangus, Ida
dc.contributor.author
Nolte, Christian H.
dc.date.accessioned
2023-07-25T12:13:56Z
dc.date.available
2023-07-25T12:13:56Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/40234
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-39954
dc.description.abstract
Ischemic stroke of the paramedian thalamus is a rare differential diagnosis in sudden altered vigilance states. While efforts to describe clinical symptomatology exist, data on the frequency of paramedian thalamic stroke as a cause of sudden impaired vigilance and on accompanying clinical signs and outcome are scarce. We retrospectively analyzed consecutive patients admitted to a tertiary stroke center between 2010 and 2019 diagnosed with paramedian thalamic stroke. We evaluated frequency of vigilance impairment (VI) due to paramedian thalamic stroke, accompanying clinical signs and short-term outcome in uni- versus bilateral paramedian lesion location. Of 3896 ischemic stroke patients, 53 showed a paramedian thalamic stroke location (1.4%). VI was seen in 29/53 patients with paramedian thalamic stroke and in 414/3896 with any stroke (10.6%). Paramedian thalamic stroke was identified as causal to VI in 3.4% of all patients with initial VI in the emergency department and in 0.7% of all ischemic stroke patients treated in our center. Accompanying clinical signs were detected in 21 of these 29 patients (72.4%) and facilitated a timely diagnosis. VI was significantly more common after bilateral than unilateral lesions (92.0% vs. 21.4%; p < 0.001). Patients with bilateral paramedian lesions were more severely affected, had longer hospital stays and more frequently required in-patient rehabilitation. Paramedian thalamic lesions account for about 1 in 15 stroke patients presenting with impaired vigilance. Bilateral paramedian lesion location is associated with worse stroke severity and short-term outcome. Paying attention to accompanying clinical signs is of importance as they may facilitate a timely diagnosis.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Vigilance impairment
en
dc.subject
Ischemic stroke
en
dc.subject
Paramedian thalamus
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Frequency, clinical presentation and outcome of vigilance impairment in patients with uni- and bilateral ischemic infarction of the paramedian thalamus
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1007/s00415-021-10565-y
dcterms.bibliographicCitation.journaltitle
Journal of Neurology
dcterms.bibliographicCitation.number
11
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
4340
dcterms.bibliographicCitation.pageend
4348
dcterms.bibliographicCitation.volume
268
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
33881597
dcterms.isPartOf.issn
0340-5354
dcterms.isPartOf.eissn
1432-1459