Bilateral medial thalamic infarction transported during COVID-19 postponement: a case report

DOI
  • Yamazaki Maiko
    Department of Emergency and Critical Care Medicine, Teikyo University Hospital Department of Emergency Medicine, Teikyo University
  • Miyake Yasufumi
    Department of Emergency and Critical Care Medicine, Teikyo University Hospital Department of Emergency Medicine, Teikyo University
  • Asami Masahiro
    Department of Emergency and Critical Care Medicine, Teikyo University Hospital Department of Emergency Medicine, Teikyo University
  • Oonuki Takahiro
    Department of Emergency and Critical Care Medicine, Teikyo University Hospital Department of Emergency Medicine, Teikyo University
  • Sakamoto Tetsuya
    Department of Emergency and Critical Care Medicine, Teikyo University Hospital Department of Emergency Medicine, Teikyo University

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  • COVID-19蔓延期に搬送された両側視床内側梗塞の1例

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Abstract

<p>The diagnosis and treatment of stroke are often difficult, especially while taking measures to prevent coronavirus disease (COVID-19). Herein, we report a relatively rare case of acute cerebral infarction.</p><p>An 84-year-old man visited our hospital with a complaint of impaired consciousness. Physical examination revealed constricted pupils and loss of light reflexes, which suggested cerebral infarction. However, simple computed tomography (CT) of the head revealed normal findings. Since COVID-19 pneumonia was suspected on chest CT, vascular evaluation was performed via head CT angiography without magnetic resonance imaging (MRI) of the head; thrombolysis with intravenous recombinant tissue plasminogen activator was performed. On the second day of hospitalization, reverse transcription-polymerase chain reaction assay for COVID-19 was confirmed to be negative, and brain MRI findings led to the diagnosis of bilateral thalamic infarction. Postoperatively, the patient’s impaired consciousness was resolved, and he was transferred to a rehabilitation hospital on the 58th day of hospitalization because of residual dysphagia and gait disturbance. Bilateral thalamic infarction is a relatively rare type of stroke and should be considered in the differential diagnoses in patients with sudden-onset severe consciousness impairment.</p>

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