Frontal lobe dysfunction following infarction of the left-sided medial thalamus

T. A. Sandson, K. R. Daffner, P. A. Carvalho and M. M. Mesulam
Behavioral Neurology Unit, Beth Israel Hospital, Boston, MA 02215.

We treated a 62-year-old woman who developed a dramatic change in personality and behavior following a discrete left-sided medial thalamic infarction involving the dorsomedial nucleus. Neuropsychological testing demonstrated severe impairment of complex executive behaviors that are usually associated with frontal lobe function. Electroencephalography and single-photon emission computed tomography strongly implicated dysfunction of the ipsilateral frontal lobe. This case further supports a functional and physiologic thalamofrontal linkage as part of a broader cerebral network modulating complex human behavior.

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