Thalamic haemorrhages are a common form of intracerebral haemorrhage, and usually are a result of poorly controlled long-standing hypertension, although also have other causes. When due to chronic hypertension, the stigmata of chronic hypertensive encephalopathy are often present (see cerebral microhaemorrhages).
On this page:
Clinical presentation
The clinical presentation can be incredibly varied, given the thalamus has a central and pivotal role in multiple neural pathways. Potential clinical manifestations may include 2:
downward gaze (paralysis of upward gaze)
small pupils (lack of light pupillary response)
depressed consciousness
apathy
hypersomnolence
disorientation
visual hallucinations
aphasia
neglect
memory deficits
visuospatial dysfunction
pain and sensory anomalies (including Déjerine-Roussy syndrome)
Radiographic features
CT
Thalamic haemorrhage is easily recognisable on CT as hyperdensity within the thalamus.
There are many predictors of haematoma expansion potentially evident on CT, which are discussed in depth in the main intracerebral haemorrhage article.
MRI
The appearance of haemorrhage on MRI varies with time and to some degree the size of the haematoma (see ageing blood on MRI).
Treatment and prognosis
Management is generally medical, and does not differ for other causes of intracerebral haemorrhage - please see the article on intracerebral haemorrhage for further discussion 4. In selected patients, there may be a role for decompressive craniectomy 5.
Unable to process the form. Check for errors and try again.