Impairment of memory and affect in a patient with reversible bilateral thalamic lesions due to internal cerebral vein thrombosis

A 39-year-old woman suffered from an extensive bilateral lesion in the region of the thalamus. The damage, caused by a primary thrombosis of the internal cerebral veins, turned out to be reversible to a considerable degree detected by repeated CT-and MR-imaging after 2, 4 and 9 months. In spite of the partial, structural recovery the patient remained severely impaired on both cognitive and affective levels. The key functions involved were an anterograde verbal and figural memory impairment, depressed arousal and attentional levels, affective flattening, lack of prosody and a depressive irritable mood. These findings illustrate that thalamic lesions of a certain extent not only influence memory functioning, but have in addition, severe consequences for emotional behavior.