Case 88

 A seventy eight-year-old female found herself dizzy and unsteady on foot in the morning and called an ambulant car. She was transported to emergency outpatient clinic of the local hospital 20 minutes away by car. When she arrived the hospital, she lost her consciousness and paralysis of upper and lower extremities. Brain CT revealed thalamic hemorrhage associated with perforation to ventricles. Intraventricular drainage was conducted within that day. Her consciousness was getting improved, spontaneously opening her eyes and uttering words. Thirteen days later, ventricular drainage was withdrawn. Doctors mentioned to her family, “If the ventricles were becoming dilated, drainage operation would be scheduled to re-perform”. But her family would not accept their offer. She preserved activity of daily life but after attack of thalamic hemorrhage, basic motion deficit, application motion deficit and higher brain dysfunction were found. Her weakness of upper and lower extremities was improved by rehabilitation.

 She was transported and admitted to our hospital for further rehabilitation.

Based on symptoms and findings on brain CT (Fig. 1), what artery is responsible to hemorrhage?

1. Tuberothalamic (polar) artery

2. Paramedian (thalamic perforating = Percheon) artery

3. Inferolateral (Thalamo-geniculate) artery

4. Posterior choroidal artery

5. Anterior choeoridal artery

answer

2018.1.17