Teaching neuroimages: bilateral anterior thalami and fornix macrohemorrhage in Wernicke-Korsakoff syndrome.

Abstract

A 55-year-old man with alcoholism required sigmoid resection for complicated diverticulitis. A few weeks after starting parenteral nutrition, he developed multidirectional gaze nystagmus, gait ataxia, and confusion, leading to the diagnosis of Wernicke encephalopathy. Thiamine treatment was started and his symptoms improved, helping to confirm the diagnosis. However, the patient developed memory loss consistent with Korsakoff syndrome due to hemorrhage involving the fornix and the bilateral anterior thalami (figure). More typical fluid-attenuated inversion recovery lesions (mamillary bodies, tectal plate, and periaqueductal area), which may be reversible,1 were not seen. Macroscopic hemorrhage is rarely observed in Wernicke-Korsakoff syndrome2,3 and is associated with poor prognosis.3 AUTHOR CONTRIBUTIONS Dr. Nazarov: drafting/revising the manuscript, analysis or interpretation of data, contribution of vital reagents/tools/patients, acquisition of data, study supervision. Dr. Jeannin: drafting/revising the manuscript, study concept or design, contribution of vital reagents/tools/patients, acquisition of data, study supervision. Dr. Mejdoubi: drafting/revising the manuscript, analysis or interpretation of data. Dr. Signate: drafting/revising the manuscript. Dr. Smadja: drafting/revising the manuscript, analysis or interpretation of data.

DOI: 10.1212/WNL.0b013e31823a0ca5

Statistics

050010001500201220132014201520162017
Citations per Year

592 Citations

Semantic Scholar estimates that this publication has 592 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Nazarov2011TeachingNB, title={Teaching neuroimages: bilateral anterior thalami and fornix macrohemorrhage in Wernicke-Korsakoff syndrome.}, author={Boris Nazarov and S{\'e}verine Jeannin and Mehdi Mejdoubi and A{\"{i}ssatou Signat{\'e} and Didier Smadja}, journal={Neurology}, year={2011}, volume={77 22}, pages={e129} }