{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:01:07Z","timestamp":1781244067368,"version":"3.54.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Radiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Isolated thalamic lesions with post-contrast T1 hyperintensity in children may mimic arterial infarction, cerebral venous thrombosis, inflammatory disease, or neoplasm. Structured interpretation of standard magnetic resonance imaging (MRI) sequences, particularly diffusion-weighted imaging\/apparent diffusion coefficient (DWI\/ADC) correlation and interval follow-up, can help distinguish these entities. Posterior thalamic infarction in a distribution compatible with posterior choroidal artery territory is rare in pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A previously healthy 15-year-old female developed headache and blurred vision on the day of tetanus-diphtheria (Td) vaccination, followed by progressive right hemibody numbness, impaired hand dexterity, and severe cold allodynia over 10 days. Examination localized to the left thalamus, consistent with D\u00e9jerine-Roussy syndrome. MRI on 2 June 2024, day 10 after symptom onset, showed DWI hyperintensity with subtle corresponding ADC reduction in the left posterior thalamic\/pulvinar lesion, supporting early-subacute infarction. T2\/fluid-attenuated inversion recovery (FLAIR) distribution was compatible with posterior choroidal artery territory involvement. Susceptibility-weighted imaging (SWI) showed no hemorrhage or venous-congestion pattern. Post-contrast MPRAGE demonstrated patchy T1 hyperintensity interpreted as probable enhancement, but true enhancement could not be definitively confirmed because corresponding pre-contrast T1-weighted images were unavailable. Etiologic workup was unrevealing, and the event was classified as cryptogenic pediatric arterial ischemic stroke (AIS). Follow-up MRI showed reduced post-contrast T1 hyperintensity and encephalomalacic evolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The unilateral territorial pattern, DWI\/ADC abnormality, lack of hemorrhagic venous features, and follow-up maturation favored arterial infarction over venous thrombosis or neoplasm. Available post-contrast images showed no obvious filling defect of the major dural venous sinuses or principal deep venous structures, although dedicated magnetic resonance venography\/computed tomography venography (MRV\/CTV) was not performed. Corresponding pre-contrast T1 images were unavailable, limiting definitive enhancement assessment. The temporal association with Td vaccination is reported for pharmacovigilance; causality cannot be established from a single case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case illustrates a rare adolescent posterior thalamic infarct presenting as D\u00e9jerine-Roussy syndrome and highlights the value of DWI\/ADC and follow-up MRI in evaluating thalamic lesions with post-contrast T1 hyperintensity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fradi.2026.1869031","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:49:00Z","timestamp":1781243340000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Structured MRI assessment of posterior thalamic infarction in a distribution compatible with posterior choroidal artery territory presenting as D\u00e9jerine-Roussy syndrome in an adolescent: differentiating arterial ischemia from venous thrombosis and thalamic neoplasm"],"prefix":"10.3389","volume":"6","author":[{"given":"ZainEdeen","family":"Zyadah","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala","family":"Issa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Issa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Arab American University","place":["Ramallah, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anees","family":"Naser","sequence":"additional","affiliation":[{"name":"Department of Neurology, Al-Makassed Hospital","place":["Jerusalem, 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