Jump to Blood supply - The thalamus derives its blood supply from a number of arteries: the polar artery (posterior communicating artery), paramedian thalamic-subthalamic arteries, inferolateral (thalamogeniculate) arteries, and posterior (medial and lateral) choroidal arteries. These are all branches of the posterior cerebral artery.Thalamic nuclei · Hypothalamic · Paraventricular nucleus · Ventromedial nucleus. Thalamic blood supply varies between individuals regarding the origin of each branch vessel, artery position, and nuclei tributary area irrigated by each branch. Nice illustration p of Stroke Syndromes, ed by Bogousslavsky and Caplan, first edition. Polar artery of the thalamus (also tuberothalamic.
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Surrounding edema as well as central necrosis may be seen in HIV-related lymphoma. In contrast to glioblastoma, there is less or absent peritumoral edema, and necrosis and hemorrhage are less common in lymphoma.
[Vascular syndromes of the thalamus].
Reduced diffusion has been reported occasionally. Lymphoma responds often dramatically blood supply of thalamic frequently disappears on MRI but temporarily to steroid blood supply of thalamic and radiation therapy.
A patient with primary CNS lymphoma involving the left-sided thalamus, the internal capsule, and the anterior part of the corpus callosum seen as hypointensity on axial unenhanced T1-weighted imaging ahyperintensity on coronal T2-weighted b and axial FLAIR c imaging, with multifocal enhancement on axial d and coronal e gadolinium-enhanced T1-weighted imaging.
Metastasis Metastatic thalamic lesions are infrequent and are most often seen in the presence of other metastatic brain lesions. Lesion characteristics depend on the primary malignancy but are most often present with mass effect, surrounding edema, and contrast enhancement.
Encephalitis Rare cases of infectious encephalitis involving the thalamus have been described.
- Thalamus - Wikipedia
- Stroke Notes: Blood supply of the thalamus and strokes
In these cases, thalamic lesions often coexist with more typical encephalitis lesions [ 17 ]. Associated diffusion restriction, hemorrhage, or gadolinium-enhancement can be sometimes observed. Familial or recurrent cases of infection-triggered blood supply of thalamic necrotizing encephalopathy can be caused by a RANBP2 gene mutation blood supply of thalamic 18 ].
A patient with Mycoplasma pneumoniae-related acute necrotizing encephalitis involving symmetrically the posterior part of the internal capsule arrowheads and the posterolateral portion of the thalamus arrows on both sides, seen as hyperintensity on both T2-weighted a and FLAIR b imaging.
Brain Abscess Brain abscesses are usually located supratentorially at the gray-white matter junction with radiological characteristics varying with the stage of abscess development.
Deep gray matter including thalamic involvement is sometimes observed Figure Typical MRI characteristics include restricted diffusion on diffusion-weighted imaging because of a high protein contentring blood supply of thalamic on gadolinium-enhanced T1-weighted imaging, and surrounding T2 and FLAIR hyperintense edema.
A blood supply of thalamic with several brain abscesses involving the right thalamus arrows and the basal ganglia, with ring enhancement on gadolinium-enhanced T1-weighted imaging a and restricted diffusion seen as hyperintensity on DWI imaging b.
Progressive Multifocal Leukoencephalopathy The JC-virus-related progressive multifocal leukoencephalopathy typically occurs in immunocompromised patients and has a high mortality.
Lesions are often hyperintense on DWI. Contrast enhancement is most often absent although faint enhancement can be sometimes observed at the periphery.
Enhancement seems to be more frequent in natalizumab-induced progressive multifocal leukoencephalopathy cases.
In these patients, small punctuate T2-hyperintense lesions in the immediate vicinity of the main lesions are blood supply of thalamic seen. T1-hyperintense signals can be found during and after the immune reconstitution inflammatory syndrome phase of progressive multifocal leukoencephalopathy.
Surviving patients typically show profound atrophy of the involved brain structures in the chronic phase of the disease. Diffuse white matter and associated left frontal cortical and left thalamic arrows involvement seen as hyperintensity on FLAIR aDWI band ADC map c in a patient blood supply of thalamic natalizumab-related for multiple sclerosis progressive multifocal leukoencephalopathy.
MRI abnormalities, together with the presence of clinical signs, periodic sharp wave complexes on electroencephalogram, and protein in the cerebrospinal fluid, make a premortem diagnosis of probable sporadic Creutzfeldt-Jakob disease possible [ 19 ].
[Vascular syndromes of the thalamus].
MRI signal blood supply of thalamic in early stage disease can be absent or very subtle. Two different sporadic CJD patients patient 1, a and b; patient 2, c and d showing in patient 1 bilateral caudate nucleus and putaminal arrows and to a lesser degree posteromesial and pulvinar thalamic arrowheads hyperintensities on DWI a and FLAIR imaging blood supply of thalamic and in patient 2 bilateral posteromesial thalamic arrowheads and multifocal cortical arrows hyperintensities on DWI cseen as hypointensity on ADC map d.
Anterior predominance of the thalamic involvement can be seen in patient 2.
In sporadic Creutzfeldt-Jakob disease, there is an anterior predominance of basal ganglia MRI changes i. Deep grey matter signal changes are most often bilateral asymmetrical or symmetrical although unilateral involvement can be seen.
In case blood supply of thalamic thalamic involvement, signal abnormalities are most typically seen in the posteromesial portion. In young sporadic Creutzfeldt-Jakob patients, thalamic involvement is sometimes more severe than in the anterior basal ganglia structures.
In these young patients, some authors blood supply of thalamic signal changes predominant in the anterior portion of the thalamus. Laminar Necrosis Laminar necrosis typically involves the cortex but has also been reported in the basal ganglia and the thalami Figure 24 [ 22 ].