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Thalamic Nomenclature

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The tuberothalamic artery originates from the middle third of the posterior communicating artery. Within thalamus it follows the course of the mamillothalamic tract. It is absent in approximately one third of the normal population, in which case its territory is supplied by the paramedian artery. 22 The tuberothalamic artery irrigates the reticular nucleus, ventral anterior nucleus (VA), rostral part of the ventrolateral nucleus (VL), ventral pole of the medial dorsal nucleus (MD), mamillothalamic tract, ventral amygdalofugal pathway, ventral part of the internal medullary lamina, and anterior thalamic nuclei: anteromedial (AM), anteroventral (AV), and anterodorsal (AD). Percheron 13 concludes that the anterior nuclear group is not supplied by this tuberothalamic artery but rather by the posterior choroidal artery, an assertion reflected in the discussion of Von Cramon et al. Halston Heritage Leather PointedToe Mules Pick A Best Online Discounts Cheap Price Cheap Sale Geniue Stockist Many Kinds Of Buy Cheap Cheap bGue3xkk
This relationship is questionable, however, given the anatomic proximity of the tuberothalamic artery and the mamillothalamic tract to the AM/AV/AD nuclei and the demonstration 25,27 of involvement of the anterior nuclei along with the VA, VL, mamillothalamic tract, and internal medullary lamina, which are known to be supplied by the tuberothalamic artery.

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Figure 5. Diffusion-weighted MRI of acute thalamic infarction in 2 patients. A, Extensive tuberothalamic artery territory infarction on the left (right of image), as well as small lesions in the territory of the inferolateral arteries on the right. B and C, Bilateral infarction in a teenager with patent foramen ovale. The infarcted region is in the tuberothalamic artery territory, although this pattern of bilateral stroke is more usually seen after paramedian artery infarcts. This case is likely an example of the paramedian artery irrigating both the paramedian and the tuberothalamic “territories.” The patient made a complete recovery, and follow-up MRI scans revealed only minute lesions.

The major features of tuberothalamic infarction are impairment of recent memory, impairment of new learning, and temporal disorientation. These are more prominent with left-sided lesions, which also involve both verbal and visual memory impairments. Visual memory impairments are seen after right-sided lesions, and these in general result in less pervasive cognitive impairment. Von Cramon et al 21 considered the amnestic syndrome to represent a disconnection between anterior thalamic nuclei and hippocampal formation by virtue of the disruption of the mamillothalamic tract and between amygdala and anterior nuclei by damage to the amygdalothalamic projections passing through the internal medullary lamina. This conclusion was supported by the patient of Graff-Radford et al, 42 who developed a severe amnestic syndrome after infarction of the internal medullary lamina. These authors used a monkey tract tracing study to confirm that the ventral amygdalofugal pathway that links the amygdala with the medial dorsal thalamic nucleus runs through the internal medullary lamina.

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