Thalamic Stroke Symptoms: What to Look Out For

Article by Moody Neuro

Right at the center of the brain is a walnut-shaped mass responsible for processing nerve signals for sensation, movement, and mental cognition. This is the thalamus, the designated “relay station” that transmits signals from the body to the brain and vice versa. Despite its small size, it has many complex functions and plays such an important role that a stroke in this part of the brain can result in various, often lifelong, health complications.

A stroke is a serious, life-threatening condition that must be treated as quickly as possible. Every second of delay in treating a stroke will worsen the odds of a patient’s survival. It is crucial, therefore, to be aware of its symptoms and recognize them as they are happening.

Understanding the functions of the thalamus makes it easier to recognize thalamic stroke symptoms. Learn more about thalamic stroke and its symptoms in this article.

The Thalamus

All biological, cognitive, and socioemotional functions involve passing signals from various parts of the body to the brain. As the signal relay center, the thalamus receives all signals before they are routed to the cerebral cortex for processing. Almost all information about motor movement and sensory information passes through the thalamus.

  • Sensory information – The thalamus supports information processing for taste, touch, hearing, and sight. It does not support information processing for smell; the olfactory cortex is responsible for smell.
  • Motor information – The thalamus transmits all nerve signals for voluntary and involuntary movement through motor pathways through and from the brain.
  • Cognitive function and memory recall – As part of the limbic system, the thalamus is involved in processing and regulating thinking (as in learning), memories, emotions, and arousal. It also helps us focus our attention and filter out the unnecessary information bombarding our senses all at once.
  • Mood and motivation – The thalamus is involved in emotion processing and is critical in regulating mood and motivated behaviors.
  • Consciousness – The very nature of the thalamus’ functions makes it the gateway to consciousness, helping us stay awake and alert to our bodies and surroundings.

Inside the thalamus are various nuclei, each responsible for processing sensory impulses from specific parts of the body. For example, the dorsomedial nucleus becomes active when a person is organizing, planning, and using higher cognitive thinking. When you move and do physical activities, the ventrolateral nucleus lights up. The pulvinar and lateral geniculate nuclei interpret what we see, while the medial geniculate nucleus helps us understand what we hear.

All these bodily and cognitive operations become compromised when a stroke occurs. Therefore, symptoms of a thalamic stroke involve irregularities in these functions.

What Is a Thalamic Stroke?

A stroke is a non-traumatic brain injury characterized by a disruption of blood flow to the brain. Without blood to deliver oxygen and nutrients, the affected brain cells and tissues quickly deteriorate and die. A thalamic stroke occurs when blood flow to the thalamus is constricted or stopped.

Strokes, in general, are either ischemic or hemorrhagic. 

  • Ischemic stroke – This is due to blocked blood vessels, usually involving a clot.
  • Hemorrhagic stroke – This happens when blood vessels rupture and blood pools where it shouldn’t, depriving some parts of the brain of the vital oxygen and replenishments it needs.

Regardless of the cause, people who suffer a stroke manifest immediate side effects. In the case of thalamic stroke, patients exhibit symptoms involving motor movement, cognitive processing, and sensory function.

Common Thalamic Stroke Symptoms

The following are the most common and telltale signs of thalamic stroke:

1. The known symptoms of a stroke – People who experience a stroke show similar symptoms, which are abbreviated in an awareness campaign known as “BE FAST.”

  • B – Balance poblems, specifically loss of balance exacerbated by dizziness or a headache.
  • E – Eyes, referring to blurred vision, double vision, involuntary eye movements, or total loss of sight in one or both eyes.
  • F – Face, half of which will be noticeably droopy due to sudden facial weakness.
  • A – Arms and legs become weak, usually manifesting as hemiparesis or one-sided muscle weakness.
  • S – Speech suddenly becomes garbled and often nonsensical, but the patient may be unaware that their words don’t make sense.
  • T – Time, a reminder to call 911 immediately if someone has one or more of the above symptoms.

Regardless of where the stroke occurs in the brain, any or all of these symptoms may be present. If you or someone you know suddenly stumbles, loses balance, or walks with an unstable gait; complains of sudden sight problems; slurs their words and becomes incomprehensible mid-conversation; suddenly feels weak on one side of their body, and/or half their face droops, call a medical emergency hotline immediately.

2. Thalamic pain – People who suffer thalamic stroke experience a burning, freezing sensation along with intense pain in the head, arms, or legs. Also called central pain syndrome, it is essentially a mixture of pain sensations that is similar to what people with Multiple Sclerosis (MS) feel.

3. Loss of pain perception – Since the transmission of sensory impulses becomes disrupted when a stroke occurs, some patients may experience the opposite of thalamic pain and become unable to perceive pain signals instead. For example, they may become unable to discern temperature changes and can’t tell if something is hot or cold.

4. Behavioral and mood changes – Given the role of the thalamus in mood regulation, abrupt and inexplicable mood and behavioral changes can also be a symptom of thalamic stroke.

5. Higher pain sensitivity – A side-effect of central pain syndrome, a patient suffering from thalamic stroke may develop exaggerated pain sensitivity in the face, arms, and legs.

Post-Stroke Side Effects

We’ve heard stories of people suffering and surviving a stroke without anyone’s knowledge. The brain was able to rewire itself and divert activity from the damaged tissues to the healthy areas (a natural process called neuroplasticity), making an unknown stroke patient a survivor.

This can also happen to people who suffer thalamic strokes. Survivors may exhibit the following side effects in the short term or long term, depending on the severity of their stroke.

  • Fatigue – Many thalamic stroke survivors experience physical and mental fatigue weeks or months afterward.
  • Hypersomnia – Another common experience of thalamic stroke survivors is hypersomnia, a sleep disorder that makes someone sleep longer than usual, but they will still wake tired and feel unrefreshed. Sleep disturbances are to be expected because the thalamus is also involved in sleep regulation.
  • Emotional volatility – There is a high chance that survivors will have difficulty managing their emotions. For example, a survivor can become highly irritable when they used to be good-natured before the stroke. Survivors may also experience depression and personality changes as the brain rewires sensory pathways within the limbic region. This is why neuropsychology and counseling are integral to a stroke recovery program.
  • Speech problems – Communication difficulties are a common after-effect of thalamic stroke. Patients may have difficulty understanding and speaking language during a stroke and after. Thus, many survivors must relearn speaking and communicating, as forming words and sentences will become challenging.

These side effects may be temporary, with patients improving and recovering lost abilities through physical rehabilitation. Unfortunately for others, these changes stay with them for the rest of their lives.

If someone you know manifests post-stroke symptoms, encourage them to consult a doctor. It’s better to be proven wrong than ignore the possibility and lose the chance to pre-emptively avoid another, more severe stroke.

Seek Personalized Care for Thalamic Stroke Patients

Learning and remembering the symptoms of a thalamic stroke can help you save lives. Time is essential for people who suffer a stroke as the window for recovery can be very narrow, sometimes down to a few precious minutes. The sooner someone you love receives treatment, the higher the chance of recovery. 

Every patient’s situation is unique, even if the circumstances and symptoms are similar. Factors like the patient’s health, self-discipline, and personal drive can affect their recovery. For this reason, it would benefit a thalamic stroke survivor to receive personalized care after their harrowing experience.

Moody Neurorehabilitation, an institution dedicated to the care and rehabilitation of people who have suffered brain injury, can provide the high-quality, personalized care you and your loved ones deserve. 

We are an industry leader in post-acute neurorecovery programs, providing every patient with highly specialized and comprehensive inpatient and outpatient care. We offer various treatment programs and therapies like counseling, speech therapy, physical rehab, occupational therapy, recreational therapy, and more. We are committed to helping patients relearn and acquire new skills to help them rejoin their community and enjoy a high quality of life. 

Our passionate and experienced specialists at Moody Neurorehabilitation are ready to help. Inquire today.

Sources:

https://my.clevelandclinic.org/health/body/22652-thalamus

https://www.ncbi.nlm.nih.gov/books/NBK542184/

https://www.healthline.com/health/thalamic-stroke#diagnosis

https://www.medicalnewstoday.com/articles/thalamic-stroke

https://www.stroke.org/en/about-stroke/stroke-symptoms

https://www.webmd.com/stroke/what-to-know-thalamic-strokes

https://www.cdc.gov/stroke/treatments.htm

https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/stroke-recovery-timeline

https://www.upmc.com/services/rehab/rehab-institute/conditions/stroke/after-stroke