Talamushemorhagiasta

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J Clin Neurosci. 2005 Jun;12(5):559-61.

Prognostic predictors of thalamic hemorrhage.

Shah SD¹, Kalita J, Misra UK, Mandal SK, Srivastava M.

Author information

Abstract

BACKGROUND AND OBJECTIVE:

There is no study evaluating the role of clinical, evoked potential and radiological parameters in the prognosis of thalamic hemorrhage employing multivariate logistic regression analysis, thus we aimed to evaluate the role of these parameters in predicting the 3 month outcome following thalamic hemorrhage.

SETTING:

Tertiary care referral teaching hospital.

METHODS:

Fifty-three patients with CT proven thalamic hematoma were evaluated. Conscious level was assessed using the Glasgow Coma Score (GCS), severity of stroke by the Canadian Neurological Scale (CNS), while muscle tone, tendon reflexes and power were also recorded. Hematoma size and type, and evidence of ventricular extension were obtained from the CT scan. Hematomas were classified as (A) thalamic with postero-lateral extension or (B) thalamic without postero-lateral extension. Central motor conduction to upper limb and median somatosensory evoked potentials (SEP) were recorded. Outcome was defined at 3 months on the basis of the Barthel Index (BI) with good being a BI of 12 or greater and poor a BI of less than 12. Best predictors of outcome were evaluated by single variable logistic regression analysis followed by multivariate logistic regression.
 http://www.massgeneral.org/stopstroke/assets/PDFs/barthel_index.pdf
(Huom: Barthelindex on 100 jos henkilö on toipunut ja  hyvässä kunnossa). 

RESULTS:

Age ranged between 35 and 85 years; 18 were women. Mean GCS was 10.4 and CNS was 3.9. Thirty-one patients had type A hematomas and 22 type B. The hematoma was small in 5, medium in 35 and large in 13 patients. Ventricular extension was present in 34 patients. Motor evoked potentials were unrecordable in 36 and central motor conduction time was prolonged in 8 patients. Median SEP was unrecordable in 37 and N9-N20 conduction time was prolonged in 2 patients. At 3 months, 8 patients had died, 24 had good and 21 had poor outcome. On univariate logistic regression analysis diabetes mellitus, GCS, pupillary asymmetry, CNS score, type and size of hematoma and motor and somatosensory evoked potentials were significant in relation to outcome. On multivariate logistic regression analysis, the best predictors of outcome at 3 months were the type of hematoma and CNS score.

CONCLUSION:

CNS score and CT appearance of hematoma are the best predictors of 3 month outcome following thalamic hemorrhage. The proposed model for outcome assessment is simple and easy to apply and could have wide clinical application.

PMID:

15936200

DOI:

10.1016/j.jocn.2004.08.010

[Indexed for MEDLINE]

Thalamuksen osuus kivun seulonnassa ja kontrollissa

https://www.ncbi.nlm.nih.gov/pubmed/28978414

Neuroscience. 2017 Oct 1. pii: S0306-4522(17)30695-4. doi: 10.1016/j.neuroscience.2017.09.042. [Epub ahead of print]

Acute and chronic pain processing in the thalamocortical system of humans and animal models.

Groh A¹, Krieger P², Mease RA³, Henderson L⁴.

Abstract

The transmission of noxious stimuli from peripheral receptors to the cortex involves multiple central ascending pathways

• . While projections to areas in the brainstem and diencephalon are likely involved in mediating the immediate behavioral responses to pain,

•  the assessment of the sensory and emotional/motivational components of pain are likely processed in parallel ascending pathways that relay in the thalamus on their way to the cerebral cortex.

•   In this review we discuss experimental animal and human findings that support the view that a lateral thalamocortical pathway is involved in coding the sensory discriminative aspects of pain, 

•  while a medial thalamocortical pathway codes the emotional qualities of pain.

 In addition, we outline experimental animal and human evidence of functional, anatomical and biochemical alterations in thalamocortical circuits that may be responsible for altered thalamocortical rhythms and the persistent presence of pain following nervous system damage.

 Finally, we discuss advances in clinical and preclinical development of chronic pain treatments aimed at altering neural and glial function.

Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:

central pain generator; deafferentation; emotional pathways; sensory-discriminative pathways; thalamocortical dysrhythmia

PMID:

28978414

DOI:

10.1016/j.neuroscience.2017.09.042
Kuvia Thalamus-releestä.
 https://www.youtube.com/watch?v=9ktz0OqtNIA
https://www.youtube.com/watch?v=2fvLkAztm84
https://www.youtube.com/watch?v=fki7AmLma_I

• http://www.dontbeasalmon.net/images/photos/Thalamus%20nuclei.jpg
• Vasen thalamus ylläolevassa projektissa. molemmat  alla olevassa projektissa.
•  https://image.slidesharecdn.com/thalamus-150226105329-conversion-gate01/95/thalamus-7-638.jpg?cb=1424969861
•  Kuva  Diencephalon aivosta, jonka osa on Thalamus ja Hypothalamus, sekä  aivorungosta, jonka osa on Pons, aivosilta. 
• http://slideplayer.com/6617331/23/images/4/Principal+Parts+of+the+Brain.jpg
•  

THALAMUS  VASCULARIZATION

• Surg Radiol Anat. 2003 Nov-Dec;25(5-6):408-15. Epub 2003 Sep 19.

  Arterial vascularization of the human thalamus: extra-parenchymal arterial groups.

  Cosson A¹, Tatu L, Vuillier F, Parratte B, Diop M, Monnier G.

  Abstract

  The problem of the arterial vascularization of the human thalamus has been debated at length. Anatomical references concerning the thalamic arterial groups are contradictory and complex, preventing any solid application in practice. It is, therefore, difficult to produce reliable anatomical radio-clinical correlation. In this work, 12 adult human cerebellums (24 hemispheres) were dissected after intra-vascular injection. With care for clarification and standardization, the extra-parenchymal thalamic arteries were classified in six groups:
  1.  pre-mamillary artery,
  2. perforating thalamic arteries,
  3.  thalamo-geniculate arteries,
   perforating branches
  4. of the postero-medial,
  5.  of the postero-lateral and
  6. of the  anterior choroidal arteries.
  
   (1)Variations in the pre-mamillary artery were rare.
  (2) The origin of the perforating thalamic artery was unilateral in two of three cases.
  (3) The origin of the thalamo-geniculate arteries arose between the posterior cerebral artery (53%) and the posterior choroidal arteries (43%).
  (4) The postero-median choroidal artery was most often single and usually gave the perforating branches for the medial aspect of the thalamus.
  (5)  The postero-lateral choroidal artery was frequently multiple and essentially gave the perforating branches for the superior aspect of the thalamus.
   The pulvinarian branches most often rose from the postero-lateral choroidal arteries (two thirds of cases) and more rarely from the postero-median choroidal arteries (one third of cases). (6) The anterior choroidal artery is a source of thalamic vascularization by its cisternal branches running towards the lateral thalamus. It can also participate in the vascularization of the pulvinar by the plexiform branches crossing the temporal horn of the lateral ventricle. This study has allowed definition of the intra-parenchymatous arterial map of the thalamus. This mapping is essential for producing anatomical radio-clinical correlations which are pertinent for therapeutic decisions.

  PMID:

  14504815

  DOI:

  10.1007/s00276-003-0153-7

  [Indexed for MEDLINE]