Abstract：
OBJECTIVE: The thalamus is the integrative hub of the brain with reciprocal connections throughout the cortex. This case report describes a right-handed 81-year-old male patient who experienced sudden onset cognitive impairment following a focal left anterior thalamic infarct.
METHODS: With consent/assent, the patient was seen for a short neuropsychological assessment 6 weeks post stroke. Neuropsychological assessment included review of medical history, collateral intake, the Toronto Cognitive Assessment, Frontal Systems Behavior Scale-Family Rating Form, the Neuropsychiatric Inventory Questionnaire, and piano performance.
RESULTS: The assessment revealed impaired performance on measures of orientation, memory, executive function, and language, as well as symptoms including hallucinations, apathy, and hypersomnolence, consistent with thalamic dementia. Remarkably, in this context, the patient maintained an ability to play piano and read music.
CONCLUSIONS: The case has implications for understanding the complex integrative functions of the thalamus, including how profound impairment can simultaneously present with cognitive strengths that may not be captured by performance on neuropsychological testing. This case also suggests that magnetic resonance imaging may be indicated in cases presenting with vascular risk factors and sudden onset cognitive impairment, given that computed tomography may not be sensitive to small subcortical infarcts.
METHODS: With consent/assent, the patient was seen for a short neuropsychological assessment 6 weeks post stroke. Neuropsychological assessment included review of medical history, collateral intake, the Toronto Cognitive Assessment, Frontal Systems Behavior Scale-Family Rating Form, the Neuropsychiatric Inventory Questionnaire, and piano performance.
RESULTS: The assessment revealed impaired performance on measures of orientation, memory, executive function, and language, as well as symptoms including hallucinations, apathy, and hypersomnolence, consistent with thalamic dementia. Remarkably, in this context, the patient maintained an ability to play piano and read music.
CONCLUSIONS: The case has implications for understanding the complex integrative functions of the thalamus, including how profound impairment can simultaneously present with cognitive strengths that may not be captured by performance on neuropsychological testing. This case also suggests that magnetic resonance imaging may be indicated in cases presenting with vascular risk factors and sudden onset cognitive impairment, given that computed tomography may not be sensitive to small subcortical infarcts.
摘要：
目的：丘脑是大脑的整合枢纽，在整个皮质中相互联系。该病例报告描述了一名惯用右手的81岁男性患者，该患者在局灶性左前丘脑梗塞后突然出现认知障碍。
方法：经同意/同意，患者在卒中后6周接受了短期神经心理学评估.神经心理学评估包括病史回顾，侧支摄入量，多伦多认知评估，额叶系统行为量表-家庭评定表，神经精神调查问卷，和钢琴演奏。
结果：评估显示在定向测量方面表现受损，记忆,执行功能，和语言,以及包括幻觉在内的症状，冷漠,和嗜睡，与丘脑痴呆一致。值得注意的是,在这种情况下，患者保持弹钢琴和阅读音乐的能力。
结论：该案例对理解丘脑的复杂整合功能具有重要意义，包括严重的损害可以与认知优势同时呈现，而神经心理学测试的表现可能无法捕捉到。该病例还表明，在出现血管危险因素和突发性认知障碍的病例中，可能需要磁共振成像。考虑到计算机断层扫描可能对小的皮质下梗塞不敏感。
方法：经同意/同意，患者在卒中后6周接受了短期神经心理学评估.神经心理学评估包括病史回顾，侧支摄入量，多伦多认知评估，额叶系统行为量表-家庭评定表，神经精神调查问卷，和钢琴演奏。
结果：评估显示在定向测量方面表现受损，记忆,执行功能，和语言,以及包括幻觉在内的症状，冷漠,和嗜睡，与丘脑痴呆一致。值得注意的是,在这种情况下，患者保持弹钢琴和阅读音乐的能力。
结论：该案例对理解丘脑的复杂整合功能具有重要意义，包括严重的损害可以与认知优势同时呈现，而神经心理学测试的表现可能无法捕捉到。该病例还表明，在出现血管危险因素和突发性认知障碍的病例中，可能需要磁共振成像。考虑到计算机断层扫描可能对小的皮质下梗塞不敏感。
