The thalamus is deep in the center of the brain. It controls important functions, including sensation, memory, and balance. A thalamic stroke occurs when there is a disruption in blood flow to the thalamus.

A thalamic stroke is a type of lacunar stroke. A lacunar stroke causes a small hole or space in the brain due to damaged nerve cells. These strokes can cause significant physical and cognitive disabilities.

Thalamic strokes can be ischemic or hemorrhagic:

  • Ischemic strokes happen when small blood vessels become blocked.
  • Hemorrhagic strokes occur when there is bleeding in part of the brain, sometimes due to a burst blood vessel.

This article examines the role of the thalamus, causes and risk factors of thalamic stroke, symptoms, secondary effects, treatment, and recovery. It also discusses diagnosis, complications, and possible outlook.

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The thalamus is about the size of a walnut and sits deep in the center of the brain. It has two small halves and serves several roles.

All the body’s senses, except smell, connect to the thalamus. This small structure transfers information from the senses to the brain.

Additionally, the thalamus helps regulate:

  • arousal
  • pain response
  • language
  • cognition
  • mood
  • motivation

A thalamic stroke occurs when a small blood vessel serving the thalamus becomes blocked. A blood clot or atherosclerotic plaque may cause the blockage. Tissue begins to die, which may lead to long-term brain damage, disability, or death.

The American Heart Association (AHA) and American Stroke Association (ASA) share resources, and they list the following manageable risk factors for stroke:

The AHA and ASA also list the following risk factors:

  • Age: Stroke is more common as people age, but younger people can also have strokes.
  • Family history: The risk of stroke increases if a family member has experienced a stroke.
  • Gender: Females have more strokes and die from strokes more often than males. An explanation is that females tend to live longer than males and have strokes at an older age.
  • Prior stroke, transient ischemic attack (TIA), or heart attack: A TIA is a brief episode of neurological symptoms occurring due to obstructed blood flow in a region of the brain.

According to the ASA, Black people in the United States experience a higher prevalence of stroke and the highest risk of death from stroke compared with other racial and ethnic groups.

Scientists do not know the exact reason why Black people have an increased risk of stroke, but they believe certain variables, such as genetic and environmental factors as well as intensive daily stressors like racism, are contributors.

Depending on the part of the thalamus affected, a thalamic stroke may cause various symptoms, including:

  • absent or abnormal sensation on one side of the face, arm, and leg
  • sensory changes involving:
    • touch
    • pain
    • temperature
    • pressure
    • vision
    • hearing
    • taste
  • mild or moderate weakness on one side of the body

Following a thalamic stroke, people may experience the following secondary effects:

Speech and language difficulties

The thalamus is involved in various cognitive and motor functions, including speech. Following a thalamic stroke, a person may lose the ability to understand language and speech. Sometimes this is temporary and improves.

Changes in behavior and mood

Since the thalamus helps regulate mood and motivation, behavioral and mood changes are common following a thalamic stroke.

Increased pain sensitivity

Some people may develop central pain syndrome, a rare condition, following a thalamic stroke. This causes increased pain sensitivity, usually in the arms, legs, and face. It is also called Dejerine-Roussy syndrome or thalamic pain syndrome.

If a blood clot causes a stroke, doctors might recommend blood thinners to dissolve the clot. Doctors may give tissue plasminogen activator (TPA) within the first 4.5 hours following stroke onset.

In the hospital, doctors focus on reducing damage from the stroke. They aim to reduce the risk factors for a secondary stroke by stabilizing a person’s blood pressure and blood glucose levels.

Recovery time will vary depending on how much damage occurred in the brain.

If doctors advise staying in the hospital, therapies like physical therapy or speech therapy may begin immediately. If they recommend recovering at home, a person can attend outpatient therapies.

Rehabilitation is a vital part of the recovery process. The majority of recovery occurs during the first 3 months after a stroke, but many people can continue to recover slowly after this time.

Recovery time

Recovery from a stroke varies by how much of the brain was affected and how soon after onset treatment began. It can take weeks, months, or years to regain function. Some people recover fully, while others have ongoing disabilities.

Small vessel disease causes lacunar strokes, and having multiple lacunar strokes can contribute to vascular dementia. Vascular dementia may develop when strokes affect several brain areas.

The main effect of thalamic stroke is diminished sensation. This may affect how a person uses their body or objects. A decrease in sensation can also lead to injuries and unawareness of pain.

Recurrent strokes can cause weakness or immobility, which can lead to other complications, including:

According to a 2022 article, recent studies indicate that lacunar stroke is associated with an increased risk of death, usually due to cardiovascular problems.

An older study published in 2014 followed 3,020 people over a mean duration of 3.6 years following their lacunar stroke. In the group, 1.78% of participants died per year. Predictors of death included age and preexisting conditions, such as diabetes and high blood pressure.

The thalamus is a walnut-sized part of the brain that lies above the hypothalamus, deep in the brain. A stroke in the thalamus is a type of lacunar stroke. It occurs when there is an obstruction in the tiny blood vessels of the thalamus.

The thalamus regulates several functions, including sensation, language, speech, mood, and behavior. After a stroke, there may be short or long-term effects on sensation, language, mood, or motor function.

A doctor may prescribe several types of therapy after a stroke, such as speech and physical therapy. Many people recover well, while some experience long-term disabilities.