Thalamic strokes due to other arteries

1. Rostral BA disease with diencephalic-mesencephalic ischemia-- superior mesencephalic arteries can form a pedicle with thalamic-subthalamic arteries. Infarct of the perimesencepahlic Periaqueductal gray, third nerve nuclei and fascicles, and intralaminar and parafascicular nuclei , median and central nuclei, superior cerebellar peduncle and its decussation, and the medial third of the cerebral peduncle (Tatemichi et al, 1987) present like a thalamic-subthalamic artery with added third nerve palsy, contralateral HP or hemiataxia, vertical one and a half syndrome, bilateral complete ptosis, down gaze or up and downgaze palsy, retraction nystagmus, and sixth nerve pseudopalsy with hyperadduction of the eyes.

2. Proximal PCA infarct with infarct of the paramedian, peduncular perforating arteries plus occipital and temporal lobes. Ipsilateral III n palsy, contralateral HP with HS loss, hemianopia, and behavioral abnormalities mimic MCA infarct. More often, infarct spares the origin of the PCA and one gets a lateral thalamic infarct plus occipital-temporal lobes such as hemianopia, amnesia, dyslexia, anomic, TSA, or visual neglect.