Thalamic Stroke: Everything to Know

A stroke is the result of an interruption of blood flow to the brain. It usually is caused by a blood clot or bleed within the brain. A thalamic stroke is a specific type of stroke that blocks blood flow to the region of the brain known as the thalamus.

The thalamus is an important structure that sends sensory information from the body to the brain. Sensory information is interpreted by the thalamus as pain, touch, and temperature.

This article will discuss thalamic stroke, including signs and symptoms, risk factors, the importance of prompt evaluation, and treatment options.

Doctor looks at MRI of brain in patient evaluated for stroke

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What Does the Thalamus Do?

The thalamus is a region in the central part of the brain that plays an important role in relaying sensory information from the body to specific parts of the brain. The thalamus acts as a critical hub of information within the brain, think of it as a sort of Grand Central Station for sensory and behavioral information.

Important brain functions such as visual processing, language processing, motor function, and pain perception all connect through the thalamus. A disruption of blood flow and damage to the thalamus carries the risk of impacting one or more of these critical functions. 

Important functions the thalamus coordinates include the following:

  • Language
  • Limb movement
  • Visual field processing
  • Pain regulation
  • Mood and motivation

What Is a Thalamic Stroke?

A thalamic stroke is a specific stroke that occurs when blood flow is disrupted to the thalamus in the brain. The disruption in blood flow causes neurons within the thalamus to become damaged. It can result in symptoms of thalamic stroke such as difficulty processing vision, inability to find words, and partial sensory and movement loss across the body.

Causes of Thalamic Strokes

Causes and risk factors vary by type of stroke.

Ischemic Strokes and Blood Clots

A common cause of stroke occurs when a blood clot forms within an artery in the brain or travels to it from elsewhere in the body. This decreases blood flow into the brain, a condition known as an ischemic stroke.

The most common cardiac (heart-related) cause of ischemic strokes is atrial fibrillation, a heart rhythm disorder that causes blood clots to form in the heart, which can travel to the brain.

Hemorrhagic Strokes

The most common cause of a hemorrhagic stroke is uncontrolled hypertension (high blood pressure). High pressure damages the small vessels, known as lacunae, in the brain over time. Eventually, these small vessels can break open leading to a hemorrhagic stroke known as a lacunar stroke.

Lifestyle Risk Factors for Thalamic Strokes and Other Lacunar Strokes

The most significant risk factor for stroke is hypertension. Uncontrolled high blood pressure can lead to damage to the small blood vessels that supply the brain. Long-term damage can significantly impair blood flow to the brain and cause a stroke.

Another notable risk factor for stroke is smoking, which can significantly increase the risk of a stroke. Cardiovascular diseases such as high cholesterol levels and high triglyceride levels can also increase the risk of stroke.

Demographic Risk for Thalamic Strokes

Strokes can affect all people, though there are certain risk factors for stroke. Men are more likely than women to suffer a stroke. In addition, Black people of any sex have the highest risk for stroke and highest mortality rate from stroke. Since 2013, Latinx/Hispanic people in the United States. have seen the largest increase in stroke-related death.

When to See a Healthcare Provider for Thalamic Stroke

A stroke is a medical emergency that requires immediate treatment. Often, what type of stroke treatment is given will be based on the exact number of minutes elapsed since symptoms developed. Do not delay. Urgent medical evaluation and treatment can potentially save brain tissue from damage. 

To diagnose a stroke, a healthcare provider will use clinical findings obtained from a neurological exam in combination with diagnostic imaging, which may include a computed tomography (CT) scan or potentially magnetic resonance imaging (MRI) of the brain.

Treatments for Specific Forms of Thalamic Stroke

Prompt treatment of stroke is critically important as it can help save brain tissue. A physician and healthcare team can evaluate the most likely cause of stroke and provide appropriate treatment. Today, a combination of medication and procedural intervention may be used to treat stroke.

Ischemic Stroke Treatment

The treatment of an ischemic stroke is based around the principle of restoring blood flow to the region of the brain that has been occluded. This treatment is known as reperfusion therapy.

One of the first approaches may be the use of a medication that dissolves clots known as tissue plasminogen activator (tPA). At specialized stroke centers, a minimally invasive procedure can be performed in which a small tube (catheter) is placed in an artery and, with specific tools, the clot can be removed to restore brain flow.

Hemorrhagic Stroke Treatment

The treatment of hemorrhagic stroke is complex and will depends on the location and extent of bleeding. In some cases, procedures to stop the bleeding may be performed.

Since the skull is a closed space, blood loss inside the skull can increase the pressure on the brain. If the bleeding is severe enough to cause increased pressure within the brain, then neurosurgical intervention may be required to remove blood and reduce pressures on the brain.

Coping After a Thalamic Stroke

Life after a stroke can look very different than before. You may need rehabilitation and physical therapy to improve mobility after a stroke. In addition, you need to make changes to the layout of your home and identify areas that are challenging to navigate.

After a thalamic stroke, thalamic pain syndrome can develop. With this syndrome, you will experience a type of pain coming from the central nervous system (brain and spinal cord).

Thalamic pain syndrome belongs in the class of conditions known as central pain syndromes. In central pain syndrome, people become hypersensitive to pain and touch. This is known as allodynia. In addition, some people with thalamic pain syndrome may experience itching, burning, or tingling around different regions of the body.

The treatment for thalamic pain caused by thalamic stroke remains challenging. Some studies have investigated the use of deep brain stimulation, where a medical device is implanted into the brain to stimulate the nerves, as a potential therapy for the treatment of thalamic pain.

Deep brain stimulation works by stimulating a separate region of the brain to help dampen the experience associated with feeling pain.

Poststroke Health Complications

The most common medical complications after a stroke are a repeat stroke, urinary tract infections, seizures, memory impairment, and post-stroke depression. Medications can be used to substantially reduce the risk and severity of these potential complications. You should continue to work with your medical care team to manage these issues as they arise. 

Treatment Options After a Stroke

Primary treatment after a stroke is focused on physical therapy, speech therapy, and rehabilitation. In addition, treatments to reduce the risk of developing another stroke in the future are crucial. This includes medications to treat the underlying cause of thalamic stroke in combination with medications to reduce the risk of stroke.

Some common medications that can be used after an ischemic stroke are:

  • Aspirin
  • Lipitor (atorvastatin)
  • Plavix (clopidogrel)
  • Xarelto (rivaroxaban)

Other treatments and medications that can be used after a stroke are:

  • Antihypertensive (blood pressure-lowering) medications
  • Lipid-lowering medications (to reduce cholesterol and triglycerides)
  • Risk factor modification, such as cessation of smoking

There also are a few medications that may be required after a stroke to help with conditions resulting from the stroke. These include drugs to improve mood. The brain changes after a stroke and depression is a common problem after suffering a stroke.

Depression medications include:

If you have seizures (episodes of erratic brain electrical activity) after a stroke, you may also be prescribed anti-seizure medications. These include:

  • Keppra (levetiracetam)
  • Depakote (valproic acid)

Poststroke Outlook

Treatment after a stroke is focused on reducing the recovering from the stroke as quickly as possible and in combination with reducing your risk of future strokes. Recovery is focused on physical therapy, speech therapy, and occupational health to help return your livelihood back to a normal baseline.

The outlook after thalamic stroke can be highly variable from person to person. Know that with advances in medical care, the recovery after a stroke is a distinct possibility for many patients.

Summary

A thalamic stroke is the result of a disruption in blood flow to the thalamic region of the brain. Thalamic strokes cause specific symptoms, such as difficulty moving the arms and legs, trouble with speech, and visual loss. Treating a thalamic stroke is focused on prompt treatment of the underlying cause of the stroke in combination with extensive rehabilitation and therapy to promote recovery.  

A Word From Verywell

A stroke is a major event in one’s life and often comes with significant changes. A stroke can impact you and your family in multiple ways. While the road to recovery is not easy, recent advances in stroke care have enabled many people to return to healthy fulfilling lives after a thalamic stroke. 

Frequently Asked Questions

  • What does damage to the thalamus cause?

    The thalamus is an important region in the brain that controls several key functions of the body, including movement of the arms and legs, eye movements, and memory.

    Damage to the thalamus in the form of thalamic stroke often results in reduced movement and strength on one side of the body. In addition, the eyes may abnormally look upwards when moving.

  • Are all thalamic strokes embolic?

    Many thalamic strokes are embolic, or the result of small blood clots. However not all strokes are the result of emboli. Determining the exact cause of a stroke often requires an integration of clinical information in combination with advanced diagnostic brain imaging such as a CT (computed tomography) scan or MRI.

  • Can the thalamus repair itself?

    The brain is a unique organ that is incredibly adaptable after an injury. Unfortunately, the brain is not able to regenerate tissue that has died. However, after an injury, the brain can repurpose and change regions of the brain to compensate and recover some lost function.

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