Simultaneous bilateral thalamic hemorrhages in adults: Case report and review of the literature

A 78-year-old woman was admitted to our emergency center with disturbance of consciousness. Computed tomography revealed bilateral thalamic hemorrhage extending up to the lateral ventricular and acute hydrocephalus. An emerging operation with endoscope was performed to remove the hematomas at the ventricular and right thalamus, and an external ventricular drain was placed. The specimen obtained from the operation revealed that the hemorrhage was caused by amyloid angiopathy. The postoperative course was uneventful, and an additional operation for hydrocephalus was not necessary. Simultaneous bilateral thalamic hemorrhages have been rarely reported, and only 15 adult cases, including our case, have been reported in the English literature. The patients were predominantly men (10 men and 5 women), and the patients' ages ranged from 39 to 80 years (mean age, 60.8 years). The most frequent symptoms were disturbance of consciousness and tetraparesis, followed by hemiparesis and aphasia. Hypertension is the major cause of this disease (46.7%). Good recovery and moderate disability were reported in 5 cases (33.3%), whereas severe disability or progression to a vegetative state was reported in 6 cases (40.0%) and death occurred in 4 cases (26.7%).