Factors Affecting The Etiology of Isolated Thalamic Infarcts And Thalamic Infarcts With Extrathalamic Involvement: The Stroke Center Experience

Şennur Delibaş Kati; Aylin Aytekin Yeşilgöz; Eylem Özaydın Göksu; Mert Van; Ecem Ağdak

Makale detayları

Factors Affecting The Etiology of Isolated Thalamic Infarcts And Thalamic Infarcts With Extrathalamic Involvement: The Stroke Center Experience

Yazarlar:

Şennur Delibaş Kati | Aylin Aytekin Yeşilgöz | Eylem Özaydın Göksu | Mert Van | Ecem Ağdak

Yayıncı:

Sakarya University

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer)

Dergi:

Sakarya Tıp Dergisi Vol.15 Issue 1, pp.85-92

Belge Tipi:

Makale

Yayın Tarihi:

3/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001343140

pISSN:

2146-409X

Anahtar kelimeler:

Özet:

 Objective: The thalamus is a control point that is a gateway for all sensory impulses except smell and contributes to regulating the sleep-wake process. Therefore, infarcts of the thalamus cause a diversity of symptoms along with a diversity of vascular anatomy. The fact that thalamic infarcts are mostly considered lacunar infarcts seems to create inadequacy in understanding the etiology. This study aimed to compare the etiologic, diagnostic, and therapeutic parameters of thalamic infarction. Materials and Methods: This retrospective study analyzed 230 patients with thalamic infarction among 820 stroke patients admitted between January 2019 and April 2022. Patients with hemorrhagic stroke, malignancy, or infection were excluded. Demographic data, comorbidities, imaging results, and treatments administered were evaluated. All these results were analyzed in two subgroups: isolated thalamic and extrathalamic involvement. Results: Bilateral thalamic involvement was 8.386 times more common in patients with extrathalamic participation. Patients using dual antiaggregants had 2.207 times higher isolated thalamic involvement, while those on oral anticoagulants had 2.378 times higher extrathalamic involvement. Pathologies in the basilar and vertebral arteries increased the risk of extrathalamic involvement by 2.660 times p0.001. Conclusion: Thalamic infarcts cannot be considered exclusively lacunar. Extrathalamic involvement has been associated with worse functional scores and arterial pathologies. The protective effects of dual antiaggregants and oral anticoagulants vary depending on whether the thalamic infarct is extrathalamic or not, emphasizing the need for individualized therapies.

 Objective: The thalamus is a control point that is a gateway for all sensory impulses except smell and contributes to regulating the sleep-wake process. Therefore, infarcts of the thalamus cause a diversity of symptoms along with a diversity of vascular anatomy. The fact that thalamic infarcts are mostly considered lacunar infarcts seems to create inadequacy in understanding the etiology. This study aimed to compare the etiologic, diagnostic, and therapeutic parameters of thalamic infarction. Materials and Methods: This retrospective study analyzed 230 patients with thalamic infarction among 820 stroke patients admitted between January 2019 and April 2022. Patients with hemorrhagic stroke, malignancy, or infection were excluded. Demographic data, comorbidities, imaging results, and treatments administered were evaluated. All these results were analyzed in two subgroups: isolated thalamic and extrathalamic involvement. Results: Bilateral thalamic involvement was 8.386 times more common in patients with extrathalamic participation. Patients using dual antiaggregants had 2.207 times higher isolated thalamic involvement, while those on oral anticoagulants had 2.378 times higher extrathalamic involvement. Pathologies in the basilar and vertebral arteries increased the risk of extrathalamic involvement by 2.660 times p0.001. Conclusion: Thalamic infarcts cannot be considered exclusively lacunar. Extrathalamic involvement has been associated with worse functional scores and arterial pathologies. The protective effects of dual antiaggregants and oral anticoagulants vary depending on whether the thalamic infarct is extrathalamic or not, emphasizing the need for individualized therapies.

 Objective: The thalamus is a control point that is a gateway for all sensory impulses except smell and contributes to regulating the sleep-wake process. Therefore, infarcts of the thalamus cause a diversity of symptoms along with a diversity of vascular anatomy. The fact that thalamic infarcts are mostly considered lacunar infarcts seems to create inadequacy in understanding the etiology. This study aimed to compare the etiologic, diagnostic, and therapeutic parameters of thalamic infarction. Materials and Methods: This retrospective study analyzed 230 patients with thalamic infarction among 820 stroke patients admitted between January 2019 and April 2022. Patients with hemorrhagic stroke, malignancy, or infection were excluded. Demographic data, comorbidities, imaging results, and treatments administered were evaluated. All these results were analyzed in two subgroups: isolated thalamic and extrathalamic involvement. Results: Bilateral thalamic involvement was 8.386 times more common in patients with extrathalamic participation. Patients using dual antiaggregants had 2.207 times higher isolated thalamic involvement, while those on oral anticoagulants had 2.378 times higher extrathalamic involvement. Pathologies in the basilar and vertebral arteries increased the risk of extrathalamic involvement by 2.660 times p0.001. Conclusion: Thalamic infarcts cannot be considered exclusively lacunar. Extrathalamic involvement has been associated with worse functional scores and arterial pathologies. The protective effects of dual antiaggregants and oral anticoagulants vary depending on whether the thalamic infarct is extrathalamic or not, emphasizing the need for individualized therapies.

 Giriş: Talamus, koku hariç tüm duyular için bir geçit, uyku-uyanıklık sürecinin düzenleyicisi ve duyusal ve motor giriş ve çıkışlar için kontrol noktasıdır. Vasküler anatominin çeşitliliği talamik enfarktların semptomlarını da etkilemektedir. Çoğunlukla laküner sendrom olarak tanı konulması, etiyolojinin anlaşılmasını daraltıyor gibi görünmektedir. Bu çalışmanın amacı, hastaların tanı ve tedavi parametrelerini karşılaştırmaktır. Gereç ve Yöntemler: Bu retrospektif çalışmada, Ocak 2019 ile Nisan 2022 tarihleri arasında başvuran 820 inme hastası arasından talamik enfarktüs geçiren 230 hasta analiz edildi. Hemorajik inme, malignite veya enfeksiyonu olan hastalar çalışma dışı bırakıldı. Demografik veriler, komorbiditeler, görüntüleme sonuçları, tedaviler ve kabul ve taburculuk sırasındaki Modifiye Rankin Skalası mRS skorlarına ilişkin veriler toplanmıştır. İstatistiksel analizler SPSS V23 kullanılarak izole ve ekstratalamik tutulumu karşılaştırdı. Bulgular: Bilateral talamik tutulum ekstratalamik tutulumu olan hastalarda 8.386 kat daha sıktı. mRS skorları hem başvuru p0.009 hem de taburculuk p0.003 sırasında ekstratalamik tutulumu olan hastalarda anlamlı olarak daha yüksekti. İkili antiagregan kullanan hastalarda izole talamik tutulum 2,207 kat daha fazlayken, oral antikoagülan kullananlarda ekstratalamik tutulum 2,378 kat daha fazlaydı. Baziler ve vertebral arterlerdeki patolojiler ekstratalamik tutulum riskini 2.660 kat artırmıştır p0.001. Tartışma: Talamik infarktlar sadece laküner etiyolojiye bağlanamaz. Ekstratalamik tutulum daha kötü sonuçlar ve arteriyel patolojilerle ilişkilendirilmiştir. İkili antiagreganların ve oral antikoagülanların koruyucu etkileri infarkt tipine göre değişmekte olup, kişiye özel tedavilere olan ihtiyacı vurgulamaktadır.

Makale detayları

Factors Affecting The Etiology of Isolated Thalamic Infarcts And Thalamic Infarcts With Extrathalamic Involvement: The Stroke Center Experience

Yazarlar:

Şennur Delibaş Kati | Aylin Aytekin Yeşilgöz | Eylem Özaydın Göksu | Mert Van | Ecem Ağdak

Yayıncı:

Sakarya University

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer)

Dergi:

Sakarya Tıp Dergisi Vol.15 Issue 1, pp.85-92

Belge Tipi:

Makale

Yayın Tarihi:

3/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001343140

pISSN:

2146-409X

Thalamus; Stroke

Extrathalamic involvement

AntiaggregantTalamus

İnme

Ekstratalamik tutulum

Sayı

Makale detayları

Factors Affecting The Etiology of Isolated Thalamic Infarcts And Thalamic Infarcts With Extrathalamic Involvement: The Stroke Center Experience

Yazarlar: Şennur Delibaş Kati | Aylin Aytekin Yeşilgöz | Eylem Özaydın Göksu | Mert Van | Ecem Ağdak

Yayıncı: Sakarya University

Ana Başlıklar: Klinik Tıp Bilimleri (Diğer)

Dergi: Sakarya Tıp Dergisi Vol.15 Issue 1, pp.85-92

Belge Tipi: Makale

Yayın Tarihi: 3/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001343140

pISSN: 2146-409X

Thalamus; Stroke

Extrathalamic involvement

AntiaggregantTalamus

İnme

Ekstratalamik tutulum

Sayı

Yazarlar:

Şennur Delibaş Kati | Aylin Aytekin Yeşilgöz | Eylem Özaydın Göksu | Mert Van | Ecem Ağdak

Yayıncı:

Sakarya University

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer)

Dergi:

Sakarya Tıp Dergisi Vol.15 Issue 1, pp.85-92

Belge Tipi:

Makale

Yayın Tarihi:

3/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001343140

pISSN:

2146-409X