Abstract
We report 3 cases of bilateral medial thalamic infarction, 2 of which were associated with midbrain infarctions. All of the cases abruptly presented with transient deterieration of consciousness as an onset symptom. Hypersomnia, a hypoactive tendency and recent memory disturbance followed as common symptoms at the chronic stage, and the cases with midbrain infarctions revealed vertical gaze palsy. The etiologies of the infarction in our cases were assessed from the results of CT scans, MR imaging, and angiography to be as follows : 1) temporary occlusion of the vertebral artery at the time of head rotation, 2) emboli possibly originating from dissection of the basilar artery, and 3) thrombo-embolism of the perforating arteries due to diabetes mellitus. Although conservative therapy resulted in no mortality, both memory and intellectual impairments handicapped the patients' normal daily living. The correlation between the clinical featurs of cerebrovascular disease and vascular anatomy of the medial thalamus is discussed with a review of the literature.
