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Mystery Case: Injuries of neural tracts in the Papez circuit following anterior thalamic infarction

An 80-year-old woman received conservative management for an infarct in the anterior thalamus (figure, A). She had shown severe memory impairment since the onset of infarction. Diffusion tensor tractography at 2 weeks after onset showed that the thalamocortical tract between the anterior thalamic nuclei and the cingulate gyrus and the mammillothalamic tract were reconstructed in the right hemisphere.1,2 By contrast, the left thalamocortical tract showed thinning compared with that of the right hemisphere and the left mammillothalamic tract was not reconstructed. This patient's memory impairment was mainly the result of injuries of these tracts in the Papez circuit.1,2