Case 93

 A sixty six-year-old male was found to sit on a street with his head in his arms because of right hand paresis. He was transported to a local hospital by ambulance. His systolic blood pressure was more than 200mHg. Medical findings revealed right hemiparesis, severe sensory disorder (his right hand feels like not to be his but others) and dysarthria (inarticulate speech). Conservative treatment using antihypertensive-drugs was effective to gradually get improvement of right hemiparesis and inarticulate speech. He was introduced to our hospital for further rehabilitation.

Based on clinical findings and brain CT and MRI (Fig. 1-3), what parts of thalamus are possibly impaired ?

1. Medial nucleus

2. Ventral anterior nucleus

3. Ventral lateral nucleus

4. Ventral posterior nucleus

5. Pulvinar

6. (Posterior limb of internal capsule)

answer

2018.2.21