VENOUS THALAMIC INFARCTION

We present 2 patients with venous thalamic infarction (VTI) due to thrombosis of the deep sinovenous system. Both cases and 5 reported patients who survived VTI showed a typical clinical picture and outcome, consisting primarily of neuropsychological deficits, followed by marked improved or, as in our, cases, complete recovery. However, most reported patients do not survive VTI. A comparison of survivors with nonsurvivors shows that with the exception of the absence of an impaired consciousness in 3 survivors, the clinical symptoms at onset were essentially identical, as were the pattern and degree of vessel occlusion in the deep sinovenous system and in the superior sagittal sinus. However, in patients who died, thalamic lesions were larger, more frequently bilateral and extended into extrathalamic structures, and there was no recanalization of the deep sinovenous system, as in our cases. Therefore, we assume that small extent of the infarcted area and concomitant edema argue in favor of a good prognosis in VTI, and in concert with recanalization resulted in the excellent clinical outcome in our patients.