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Unilateral Venous Thalamic Infarction in a Child Mimicking a Thalamic Tumor

Division of Neuropediatrics and Muscular Disorders, Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, Germany, verena.haug{at}uniklinik-freiburg.de

Michaela Linder-Lucht, MD

Division of Neuropediatrics and Muscular Disorders, Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, Germany

Barbara Zieger, MD, PhD

Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, Germany

Rudolf Korinthenberg, MD, PhD

Division of Neuropediatrics and Muscular Disorders, Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, Germany

Volker Mall, MD, PhD

Division of Neuropediatrics and Muscular Disorders, Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, Germany

Irina Mader, MD, PhD

Section of Neuroradiology, Neurocenter, University Hospital Freiburg, Germany

Unilateral thalamic infarction is a rare condition in adults. This is a case report of a young child presenting with left-sided hemiparesis of sudden onset due to an unilateral venous thalamic infarction. This was attributed to an asymmetric thrombosis of the cerebral internal veins, a partial thrombosis of the vein of Galen and straight sinus. Magnetic resonance imaging resulted primarily in the differential diagnosis of a cerebral tumor or an intracerebral abscess, leading to stereotactic puncture. Subsequent magnetic resonance venography facilitated the correct diagnosis. Heparin-induced thrombocytopenia necessitated anticoagulation treatment with hirudin and later, warfarin. The patient made a complete recovery. We conclude that unclear unilateral thalamic lesions might be symptomatic of a cerebral deep venous thrombosis and might mimic a thalamic tumor. In uncertain cases, we suggest rapid performance of magnetic resonance angiography.

Key Words: deep internal cerebral venous thrombosis • unilateral venous thalamic infarction • heparin-induced thrombocytopenia • iron deficiency

Journal of Child Neurology, Vol. 24, No. 1, 105-109 (2009)
DOI: 10.1177/0883073808321055


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