Putaminal hemorrhage disrupts thalamocortical projection to secondary somatosensory cortex: case report.
Putaminal hemorrhage presenting pure sensory stroke is rare. We describe a case of left putaminal hemorrhage presenting contralateral hemisensory disturbance without hemiparesis. A 52-year-old man developed analgesia and thermoanesthesia in the right half of his body, but deep sensation was relatively well preserved. Neuroradiological and somatosensory evoked potential findings suggested that thalamocortical sensory pathways to the secondary somatosensory cortex (S2) were involved, whereas those to the primary somatosensory cortex (S1) were spared. In experimental animals, spinothalamic projections from the thalamic nucleus input directly to S2. In humans, thalamocortical pathways are still a subject of debate, but results of recent functional imaging studies suggest that the pathway of pain inputs directly to S2 and that of tactile sensation to S2 via S1. Our findings support these reports.
Hiraga
Akiyuki
A
Department of Neurology (D3), Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. hiragaa@mail3.alpha-net.ne.jp
Sakakibara
Ryuji
R
Mizobuchi
Keiko
K
Asahina
Masato
M
Kuwabara
Satoshi
S
Hayashi
Yuhoko
Y
Hattori
Takamichi
T
D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000000981:diagnostic imaging*; D020146:Putaminal Hemorrhage / Q000503:physiopathology*; D011930:Reaction Time / Q000502:physiology; D013003:Somatosensory Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013788:Thalamus / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods