Table 1 Vascular territories of the thalamus
| Vascular territory and supplying artery | Affected Nuclei* | Clinical symptoms [4, 5, 8, 9, 11, 12, 22, 23] |
|---|---|---|
|
Anterolateral territory from tuberothalamic artery arising from posterior communicating artery |
Anterior thalamic nuclei group (AM, AV, AD) ventral amygdalo-fugal pathway ventral IML intralaminar nuclei (CL, CM, Pf) VA, RN rostral VL, ventral pole of MD mamillothalamic tract |
Neuropsychological deficits: Decreased arousal, disorientation, mood disorders, personality changes, apathy, executive and drive impairment, perseverative behavior if left-sided: Thalamic aphasia, verbal short-term and visual memory impairment, amnesic syndrome, acalculia if right-sided: Hemi-spatial neglect, visuo-spatial processing deficits, executive cognitive tasks, non-verbal information processing memory impairment, amnestic syndrome |
|
Anteromedian territory [22] varying arterial supply |
MD intralaminar nuclei (CL, CM, Pf) IML |
Hemiparesis, sensory loss, hemiataxia Neuropsychological deficits, memory impairment with severe anterograde amnesia, aphasia, agnosia and neglect, apraxia, executive dysfunction |
|
Inferomedial territory from paramedian artery arising from pre-communicating P1-Segment (PCA) |
MD posteromedial VL IML intralaminar nuclei (CL, CM, Pf) ventromedial pulvinar and LD mesencephalon (riMLF) |
Acute: Sudden disturbance of vigilance; coma Chronic: “Thalamic dementia” with cognitive deficits, decreased arousal, impaired learning, memory deficits, apraxia, temporal disorientation, altered personality with apathy, mutism and lethargy, aggression, and agitation if left-sided: Thalamic aphasia if right-sided: Visuospatial processing deficits Motor and/or sensory hemi-syndrome, oculomotor nerve palsy, vertical gaze palsy |
|
Central territory [22] varying arterial supply |
VPL intralaminar nuclei (CL, CM, Pf) |
Sensory loss, hemiparesis, ataxia Decreased vigilance, anterograde amnesia, short-term memory impairment |
|
Inferolateral territory from thalamogeniculate artery arising from P2-Segment (PCA) |
Ventroposterior complex (VPM, VPL, and VPI) VL MGB Pulvinar, LD |
Sensory loss of all modalities, hemiparesis (often transient†), hemiataxia, predominantly on the right: Postlesion thalamic pain syndrome (Déjérine-Roussy-Syndrome) Hearing impairment Behavioral changes |
|
Lateral and medial posterior territory from lateral and medial branches of the posterior choroidal artery arising from P2-segment (PCA) |
Lateral: LGB, LD, LP, inferolateral parts of pulvinar, VPL, VL Medial: MGB, posterior parts of CM and CL, pulvinar |
Dystonic posture, ataxic hemiparesis and sensory loss, visual field loss (hemi- or quadrant-anopia), neuropsychological features Sensory loss, hemiparesis, aphasia, memory impairment, hand tremor |