Thalamic stroke is one of the deadliest types of intracerebral hemorrhages that occurs in the thalamus, which is located in the lower portion of the brain. It’s typically brought on by severe bleeding in the brain tissue, which can greatly damage brain cells and reduce the functionality of either some parts of the brain or the brain as a whole.
Strokes typically occur when there’s a massive blockage or lack of sufficient blood and oxygen supply to any part of the brain. Blood flow can be prevented by an embolism, otherwise known as a blood clot, that happens as a result of a ruptured artery in the heart producing an overabundance of blood flow to different parts of the body.
Thalamus anatomy and function
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The thalamus is a chamber-like structure located above the midbrain in the hindbrain within very close proximity to the central brain. The function of the thalamus is to produce nerve fibers and send them through the cerebral cortex. Most sensory signals sent out and received by the brain must pass through the thalamus.
The thalamus has a number of important responsibilities and essential functions including regulating sleep patterns, delegating instructions to other parts of the brain in times of emergency, as well as controlling levels of consciousness. It also passes important messages and sensory signals to the cerebral cortex and induces certain sensations.
While the thalamus isn’t actually part of the brain stem, it’s located close enough to it to have some influence on its functionality. Mainly, the thalamus is responsible for receiving, processing, and passing on information or other signals from other parts of the body to the cerebral cortex. As such, it’s often referred to as the main hub of information in the brain. After sensory signals are received by the thalamic nerves, they’re then transported directly to the primary cortical area within the brain.
The thalamus plays such an integral role in productive brain functionality that if it ever becomes damaged or suffers an injury, it can cause a person to enter into a comatose state. Sensory systems that are directly controlled or impacted by the thalamus include the following:
- Visceral systems
- Visual systems
- Auditory systems
- Somatic systems
- Gustatory systems
Causes, risk factors, and symptoms of thalamic stroke
The following is an extensive list of potential thalamic stroke risk factors:
- Extremely high blood pressure
- Restricted blood flow to the brain
- Restricted oxygen levels in the brain
- High quantities of protein buildup in the brain
- Head injuries causing an abundance of bleeding in the brain tissues, which can lead to embolism
- Aneurysms
Anyone who exhibits symptoms of any of these above mentioned conditions is automatically at extremely high risk of suffering a thalamic stroke.
Conditions that directly cause thalamic stroke are equally as serious as the risk factors, if not more so as they all actively block sufficient blood flow from reaching core parts of the brain. Thalamic stroke causes include:
Stenosis of major artery:
The carotid artery supplies blood to the thalamus, so an obstruction or narrowing of the carotid branch can cause a thalamic stroke.
Thalamic or intracerebral arterial aneurysm
If an aneurysm occurs in the thalamus or its surrounding blood vessels, then the resulting immense pressure can either rupture or obstruct it enough so that blood flow can’t get through at all.
Hypoxia
Insufficient concentrations of oxygen in the bloodstream and dangerously low blood pressure means that the brain is lacking in essential vitamins and nutrients that it needs to function which can inevitably lead to an embolism and thalamic stroke.
Atherosclerotic stenosis of the basilar artery
The basilar artery is responsible for delivering oxygenated blood directly to the thalamus, so when it gets obstructed or prevented from performing its main function, the result could lead to a thalamic stroke.
All of these are serious medical conditions that require close supervision and regular examinations. As long as you maintain a well balanced and overall healthy lifestyle by eating lots of fruit, vegetables, legumes, proteins, and healthy fats combined with exercising on a regular basis, then you should be able to avoid developing these types of problems.
The following is a list of symptoms of thalamic stroke:
- Numbness throughout the body
- Stinging sensation or pain
- Inflammation throughout the body
- Inability to speak
- Severe headache
- Nausea or vomiting
- Facial paralysis
- Droopy eyelids
- Loss of balance and coordination
Complications of thalamic stroke
Another name for thalamic stroke is thalamic infarct, which basically occurs when the thalamus portion of the brain sustains any type of trauma or physical damage. A whole slew of possible complications may arise once this happens, since the thalamus is considered to be one of the most active and important parts of the brain.
Aside from controlling important brain functions such as alertness and sleep patterns as well as sending urgent signals to and from the brain to other parts of the body, the thalamus is also the central source of new memory formation and storage. Therefore, even the most minor damage sustained by the thalamus can have a severely negative impact on your brain’s ability to comprehend and store new information.
The result is a condition called anterograde amnesia, which is a subcategory that falls under the general term amnesia. This means that your brain has lost all of its ability to retain any new information such as phone numbers, people’s names, and even directions to certain destinations. People who suffer from this condition are limited in a number of ways when it comes to their daily lives as it can make for some awkward social and professional interactions with new acquaintances. On top of that, it can also make running errands a lot more difficult if you’re constantly forgetting where you parked your car.
The brain is one of the most complex mechanisms in the human body. This is characterized by the fact that everything that’s located on the left side corresponds to functions on the right side of the body and vice versa. Cases of thalamic stroke are no different. If a thalamic infarct occurs on the left side of the thalamus, then the right side of the brain is impacted.
Significant damage to the thalamus can negatively impact a person’s ability to communicate and it may even impair some hearing functionality depending on the location. Additionally, executive dysfunction (loss of decision-making abilities, self-awareness, planning and organizational skills, as well as multi-tasking abilities) and hippocampal amnesia (a type of anterograde amnesia that occurs as a result of damage to the medial temporal lobes in the brain) may also occur.
Treatment, prevention, and recovery of thalamic stroke
Thalamic stroke treatment
During the early stages of thalamic stroke or if a patient is on the trajectory to suffer a thalamic stroke, then doctors will most likely try a combination of medicinal treatment options to see which ones work best. However, if the condition is left untreated for a long time or advances to a more serious stage before being treated, then surgery will be necessary. Unfortunately, surgery is one of the most complex types of thalamic stroke treatments and could result in a slew of complications along the way.
Before the surgery, the doctors will perform an in-depth series of test to ascertain the exact nature and severity of the condition. Once the doctors determine that surgery is absolutely necessary, they can then proceed. During the procedures, the doctors will attempt to effectively remove all or as much of the damaged blood vessels as possible that are directly responsible for the hemorrhaging. There are two types of surgical thalamic stroke treatments:
Thalamic hematoma drainage: This is a very invasive surgical procedure in which the surgeons must remove blood clots that have collected around the thalamus. Prior to surgery, doctors must perform a series of detailed tests such as CT scans, MRI, and ultrasounds in order to locate the hematoma.
Thrombectomy and dilation of atherosclerotic occlusion: When the basilar artery is obstructed by blood clots, a thrombectomy surgery must be performed in order to clear it out using a catheter. Then, a stent is placed in the arterial lumen to dilate the basilar artery.
Thalamic stroke prevention
While there are no specific preventative measures that can be taken to stop the onset of a thalamic stroke, patients who’ve already suffered from one can take certain precautions at the behest of their doctors and make lifestyle changes to prevent it from happening again. Your doctor will give you a list of health instructions to follow as a method of preventing another episode from occurring.
Thalamic stroke recovery
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There’s no definitive recovery period after suffering a thalamic stroke as it’s a brain-related condition. The amount of time required as well as the quality of your recovery depends completely on the severity of the condition itself. Some cases could be more severe than others, which means that some patients will need more time to heal than others. Unfortunately, some patients may never make a full recovery and could suffer the consequences for the rest of their lives. It’s absolutely imperative to follow the instructions provided by your doctor to the best of your ability in order to ensure that you recover as much as possible.
The best way to prevent or treat a right or left thalamic stroke from occurring is to properly maintain your health and take care of your body. Schedule regular doctor’s appointments to make sure that there’s nothing out of the ordinary and try to eat healthily and exercise on a regular basis to maintain a normal blood pressure. Take all necessary precautions to reduce the amount of stress in your life and never be afraid to ask for help when you need it. Keep an eye out for all of the abovementioned signs and symptoms of thalamic stroke so that you can always stay ahead of the game and lower your risk of suffering from one.
Related: Embolic stroke: Causes, symptoms, diagnosis, and treatment