Artery

Area

Clinical

Notes

Polar

(Tuberothalamic; anterior internal optic a. of Duret; premammillary pedicle of Foix & Hillemand)

Arises from Posterior Communicating artery

Anterolateral regions.

(Reticular nucleus, mammillothalamic tract, ventral lateral nucleus, dorsomedial nucleus, lateral aspect of anterior thalamic pole). Does not supply anterior nucleus.

Abulic, apathetic.

Left: minor dysphasia

Acute amnesia with inability to make new memories.

Thalamic-subthalamic

(Paramedian thalamic of Percheron; deep interpeduncular profunda; posterior internal optic of Foix & Hillemand; thalamoperforating pedicle of Foix & Hillemand)

Arise from P1 of PCA.

Posteromedial thalamus.

(Rostral interstitial nucleus of MLF; posterior inferior portion of dorsomedial nucleus; nucleus parafascicularis; intralaminar nuclei; occasionally mammillothalamic tract)

Triad: acute decrease consciousness; neuropsychological disturbance, abnormalities of vertical gaze.

Upgaze palsy or combined up-&-down gaze palsy.

Pure downgaze pals if bilateral.

Amnesia +/- confabulation.

Compulsive need to assume sleep position & utilisation behaviour.

Second in frequency for thalamic infarct behind lateral infarct.

Commonest cause is embolism.

Thalamic dementia: mild fluent aphasia with paraphasic errors & dysnomia, preserved comprehension & repetition abilities.

Thalamogeniculate

Arise from P2 of PCA.

Ventrolateral thalamus

(Ventral posterior medial & lateral nuclei; lateral part of centromedian nucleus; rostrolateral portion of pulvinar)

Pure sensory; mixed motor & sensory; ataxic hemiparesis.

Thalamic syndrome of Dejerine & Roussey

La main thalamic (dystonic hand)

Most common thalamic infarct.

Commonest cause is microangiopathy / lipohyalinosis

Posterior choroidal

Arise from P2 of PCA

Dorsal region

(Pulvinar; posterior thalamus; geniculate bodies; anterior nucleus)

Visual field defects due to injury to lateral geniculate body eg sectoranopia, quadrantanopia

Visual hallucinosis

Less Common Infarcts

Rostral basilar artery disease with diencephalic-mesencephalic ischemia

Proximal posterior cerebral artery disease with thalamic infarction

Anterior choroidal

Optic tract; lateral geniculate body; posterior 2/3 of posterior lib of internal capsule; globus pallidus; middle 1/3 of cerebral peduncle.

Only 10% anterior choroidal artery infarcts have thalamic involvement.

Hemorrhage

Posterolateral

Hemiparesis & sensory loss

Anterolateral

Neuropsychological disturbance with mild hemiparesis & sensory disturbance

Medial

Reduced consciousness; abulia; amnesia; gaze palsies.

Dorsal

Visual disturbance.

Mild transient hemiparesis, sensory disturbance.