Thalamic infarct presenting as apparent life-threatening event in infants.
Thalamic infarction with distinct manifestations is well-described in adults but less well-delineated in children. We report two infants who presented with an apparent life-threatening event (ALTE) with very early magnetic resonance imaging (MRI) demonstrating a unilateral thalamic infarction. Subsequent MRI demonstrated bilateral changes in the brain stem and basal ganglia, which were in keeping with profound hypoxic ischaemic injury. We propose the thalamic infarction to be the primary event precipitating a profound hypoxic ischaemic injury as an alternative explanation to the neuroimaging observation.


CONCLUSIONS
Thalamic infraction may have a causal role in ALTE. Early and appropriate neuroimaging is required to detect these changes.
Gupta
Sachin
S
Department of Paediatric Neurology, Evelina Children's Hospital at Guys and St Thomas' Hospitals NHS Foundation Trust, London, UK.
Fernandez
Daphin
D
Siddiqui
Ata
A
Lin
Jean-Pierre
JP
Garside
Lydia
L
Lim
Ming
M
D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D013786:Thalamic Diseases / Q000150:complications* / Q000175:diagnosis; D013788:Thalamus / Q000473:pathology