抄録
Patients with posterior thalamic hemorrhage typically experience favorable recovery in both sensorimotor deficits and life expectancy. However, research detailing the time course of recovery after the onset is limited. Here, we present the clinical and brain imaging findings of a patient with right posterior thalamic hemorrhage, from the onset to 4 months post-event, as assessed through a range of rehabilitation examination tests. The patient demonstrated substantial improvement in sensorimotor function, particularly in ataxia. Upon discharge, the patient demonstrated minimal dependence in activities of daily living and no discernible issues on dementia tests. Despite these improvements, the patient exhibited residual impairment in generalized attention, including short-term memory, selective attention, and divided or switching attention disorders. These attention impairments appeared to negatively affect the driving simulator evaluation tests conducted at discharge. At the onset, the brain images showed a large hemorrhage area (approximately 21 mL in volume), including the ventral lateral nucleus, ventral posterolateral nucleus, and pulvinar. The lesion area converged to the posterior thalamic region, including a part of the ventral posterolateral nucleus and pulvinar, at 3 months post-event. Based on these imaging findings, this report discusses the factors contributing to the notable improvement in thalamic ataxia and the residual generalized attention disorder resulting in driving impairment. This report underscores the need for comprehensive rehabilitation program planning in cases of posterior thalamic hemorrhage, and highlights the importance of balancing recovery and potential post-discharge risks.
