Causes and Presentations of Bilateral Thalamic Lesions: A Retrospective Cross-sectional Study from a Tertiary Care Hospital

Abstract

Background and Objective:
Bilateral thalamic lesions present a significant diagnostic and therapeutic challenge due to their critical role in sensory, motor, and cognitive functions. The objective of this study was to study the causes and presentations of bilateral thalamic lesions among patients presenting to a tertiary care hospital.

Methods:
This retrospective study reviewed 40 patients aged 18–80 years admitted to Aga Khan University Hospital between 2006 and 2023 with MRI-confirmed bilateral thalamic lesions. Data collected included demographics, clinical presentations, radiological findings, and final diagnoses. The data was analyzed through SPSS 22.0.

Results:
Of the 40 cases analyzed, the most common etiology was Artery of Percheron (AOP) infarction (27.5%), followed by Wernicke’s encephalopathy (20%), Carbon monoxide poisoning (15%), lymphoma (12.5%), Fahr disease (12.5%), Cerebral Venous Sinus Thrombosis (7.5%), and Wilson’s disease (5%). Clinical presentations included altered levels of consciousness, seizures, headache, and vertigo, with MRI revealing distinct patterns for each condition.

Conclusion:
Bilateral thalamic lesions encompass a wide range of etiologies, each influencing management and prognosis differently. This study underscores the need for precise radiological evaluation and clinical correlation to guide effective treatment strategies.