Symmetrical thalamic degeneration with calcifications of infancy

F. J. DiMario Jr and R. Clancy
Department of Pediatrics and Neurology, University of Connecticut Health Center, University of Connecticut School of Medicine, Farmington 06032.

We describe the clinical and radiographic features of three premature infants with symmetric thalamic calcification recognized by computed tomographic scan on days 6, 12, and 49 of life and contrast our findings with those reported in the literature. These lesions follow prepartum or intrapartum hypoxiaischemia and are clinically distinguished by prominent bulbar dysfunction, featuring weak or absent cry, poor feeding, and facial weakness. Neonatal thalamic calcification in premature infants may serve as a radiological marker of an acute, short-lived hypoxic-ischemic event. The presence of brain-stem dysfunction, particularly of lower cranial nerves in association with thalamic calcifications, constitutes a distinctive clinical-radiological entity and usually portends a poor outcome. The presence of these calcifications implies that injury was sustained to diencephalic and brain-stem structures at least 2 to 4 weeks prior to their appearance on computed tomographic scan.