Article Text

Reminder of important clinical lesson
Subsequent bilateral thalamic haemorrhage
  1. Jesus Perez1,
  2. Claudio Scherle1,
  3. Calixto Machado2
  1. 1
    Hermanos Ameijeiras Hospital, San Lazaro 701, Havana, 10400, Cuba
  2. 2
    Institute of Neurology and Neurosugery, 29 y D, Vedado, Havana, 10400, Cuba
  1. Calixto Machado, braind{at}infomed.sld.cu

Summary

Simultaneous or subsequent bilateral thalamic haemorrhage is rare, and most reported cases are from Asian countries. An 80-year-old white Cuban man, with a history of arterial hypertension, suffered sudden onset of right hemiparesis. Computed tomography (CT) scan showed a left posteromedial thalamic haemorrhage. Two days later his condition suddenly deteriorated: blood pressure was 220/105 mm Hg, he was stuporous and tetraplegic, respiration was ataxic, and his gaze was fixed and deviated downward and inward. CT scan showed haemorrhages in both thalami, extending to the ventricles. 32 h later the patient died. There are few previous publications of simultaneous or subsequent bilateral thalamic haemorrhages and this is the first report involving a Hispanic patient. Prognosis in patients with bilateral thalamic haemorrhage is poor, and the mechanism underlying the development of subsequent and symmetrical bleeding is not clear.

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Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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