Left thalamic hemorrhage

The human brain is mainly divided into left and right brain. The function controlled by the left brain is to focus on logic, while the function controlled by the right brain is to focus on human action ability. So if the left thalamus bleeds, it will affect a person's language function. Because the left brain also controls a person's ability to speak, and the severity of left thalamic hemorrhage also needs to be judged. Because severe left thalamic hemorrhage may lead to shock or even death, how is the diagnosis of left thalamic hemorrhage determined?

1. Thalamic hemorrhage-clinical symptoms

The clinical symptoms of thalamic hemorrhage mainly depend on whether the bleeding is limited to the thalamus or extends to the surrounding adjacent areas and are closely related to the amount of bleeding. If the disease is limited to the thalamus, there will be three hemiplegia, hemisensory disturbance, and hemianopsia. The upper and lower limbs are basically equally paralyzed, and the sensory disturbance is more severe. Some people may experience thalamic pain and the sensory disturbance is not easy to recover. Most of them have no consciousness disorder. If the disease extends to the putamen, the paralysis is severe, and milder consciousness disorder such as drowsiness may occur. Thalamic aphasia may occur in the dominant hemisphere. If thalamic hemorrhage breaks into the ventricle and affects the hypothalamus, the consciousness disorder is severe and stress ulcers, central hyperthermia, neurogenic pulmonary edema or decortication rigidity may occur. Bleeding affecting the midbrain can cause anisocoria, nuclear oculomotor nerve palsy, etc.

Characteristics of thalamic hemorrhage

According to the appearance of head CT scan, it can be divided into three types:

1. Localized type: The amount of bleeding is generally <10ml, limited to the thalamus, with mild symptoms, no disturbance of consciousness, no complications, and often movement disorders and sensory disorders;

2. Thalamic basal ganglia type: The hematoma invades the basal ganglia from the outside. The patient has severe paralysis symptoms and may have typical three-sided symptoms. The amount of bleeding is generally >15ml, and there may be mild disturbance of consciousness.

3. Thalamic ventricular type: The hematoma ruptures into the lateral ventricles and the third and fourth ventricles. The amount of bleeding is generally >20ml. There are often impaired consciousness. In severe cases, midline shift occurs, causing complications such as stress ulcers, central fever, and pulmonary edema.

III. Overview of thalamic hemorrhage

Thalamic hemorrhage often has no typical symptoms, and its clinical manifestations are varied. It is more severe than putamen hemorrhage. It is difficult to determine the site of bleeding based on symptoms and signs alone. Head CT scan can determine the site and amount of thalamic hemorrhage and whether it has broken into the ventricles and invaded the internal capsule. This is of great significance for treatment and prognosis, especially for the elderly. If they suddenly develop impaired consciousness and significantly increased blood pressure, they should be aware of the high possibility of thalamic hemorrhage, and thalamic hemorrhage in the elderly is prone to breaking into the ventricles. The prognosis is good if the hematoma is limited to the thalamus, poor if it invades the basal ganglia, and even worse if it ruptures into the third or fourth ventricle.