title: [Fluctuation in bilateral thalamic infarction: diffusion study using magnetic resonance].
abstract: BACKGROUND
  Bilateral paramedian thalamic infarcts are uncommon. The most frequent clinical manifestations are acute impairment of consciousness, oculomotor abnormalities and cognitive disturbances. A fluctuating course has not been previously reported.
  
  
  METHODS
  A 66 year-old woman with a past history of arterial hypertension and diabetes was admitted to our hospital presenting four episodes of decreased consciousness and vertical gaze paresis. Neurological examination between episodes was unremarkable. Diffusion-weighted magnetic resonance imaging revealed high-signal lesions in both paramedian thalamic areas.
  
  
  CONCLUSIONS
  Fluctuating impairment of consciousness may be a clinical presentation of bilateral paramedian thalamic infarction. Atheromatous occlusion of the mouth of the paramedian thalamic penetrating artery is the most common cause. Neurological findings and diffusion-weighted images may help to define the extension and the underlying pathophysiological mechanism.
authors.affiliation: División de Neurología, Hospital JM Ramos Mejía, Buenos Aires, Argentina. jorgemaurino@hotmail.com
authors.forename: J
authors.initials: J
authors.lastname: Mauriño
authors.forename: G
authors.initials: G
authors.lastname: Saposnik
authors.forename: A
authors.initials: A
authors.lastname: Franco
authors.forename: S
authors.initials: S
authors.lastname: Lepera
authors.forename: R C
authors.initials: RC
authors.lastname: Rey
authors.forename: R E
authors.initials: RE
authors.lastname: Sica
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000503:physiopathology*; D002544:Cerebral Infarction / Q000150:complications / Q000503:physiopathology*; D003128:Coma / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D004058:Diffusion; D004172:Diplopia / Q000209:etiology; D018450:Disease Progression; D004401:Dysarthria / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008279:Magnetic Resonance Imaging; D012008:Recurrence; D013788:Thalamus / Q000098:blood supply*; D014057:Tomography, X-Ray Computed
vernacular_title: Fluctuacióń en infarto talámico bilateral: estudio con difusión por resonancia magnética.