Sudden confusion and cognitive decline due to acute infarction of the anterior thalamic nucleus (ANT) - a case report

Abstract

A 76-year-old man presented with sudden behavioral changes and cognitive decline. His clinical presentation was characterized by impaired short-term memory, strange behavior, disorientation, impaired executive function, and withdrawal. MRI of the head showed an infarcted lesion in the right thalamus, confined to the anterior thalamic nucleus. According to the characteristics of the cognitive network and evidence from different clinical and experimental studies, infarction in this critical part of the anterior thalamic nucleus can cause disruption of basal ganglia-thalamo-prefrontal circuit, resulting in confusion and cognitive decline. The combination of clinical symptoms, neuroimaging and temporal findings led to the final diagnosis of strategic infarct vascular dementia (VaD) subtype (SIVaD).