Demencia talámica secundaria a infarto agudo paramediano talámico bilateral por oclusión de la arteria de Percheron

Abstract

The anterior and medial part of the thalamus is the responsible of multiples cognitive functions through the thalamus-cortical connections. A bilateral thalamic infarction can cause a secondary dementia and these are related to a thalamocortical deafferentation with a partial recovery. We report a case of sudden onset dementia caused by bilateral thalamus lesions. A 42 smoker male, that suddenly had an acute confusional syndrome with altered language, bradypsychia, right hemiparesis and right hemisensory loss. Cranial magnetic resonance imaging showed a bilateral thalamic stroke probably due to a variant talamus irrigation (artery of Percheron type 2). From this date, in three months, the patient had attention deficit, impairment of memory retention, apathy, initiative deficit, depressive syndrome and mood changes. All these symptoms improving partially in the following six months. The thalamic stroke can cause a thalamic dementia, commonly bilateral and preferable located in the anterior and medial nuclei. In our case, cranial SPECT showed frontal hypocaptation for diaschisis phenomenon.