Abstract
A 59-year-old man was admitted to the hospital because of conscinousness disturbance. He was in agitated delirium, and was noted to have spastic tetraparesis, left central facial palsy, cortical blindness, left oculomotor palsy, down and medial deviation of the right eye, and “hyperkinetic mutism”.
CT scan showed extensive infarction in the left temporal lobe including hippocamous and temporal stem, bilateral occipital lobes, whole the left thalamus, and left half of the midbrain. About one month later, these lesions became hemorrhagic. These neurological findings persisted since his death of two years later. Judging from these neurological findings and location of the lesions, this case was regarded as the “Top of the basilar syndrome” of Caplan.
This case had such unusual finding that whole the unilateral thalamus was destructed because of infarction. The relation between the thalamic vascular supply and the mechanism producing total thalamic infarction was discussed.
