This paper looks at the exact region that strokes take place in and the chances of developing CPSP.
Not seen anything quite as precise before.
The line that is mentioned in the pdf is either above or below the fibres which connect the left and right sides of the brain together. I am not going to suggest any sufferer reads the pdf. This is almost for information purposes in case at some point in the future, this is useful or to help understand in conversations with medics.
Lemniscal in the pdf means relating to a lemniscus, which is a band of nerve fibers that transmit sensory information
Discussion point in pdf
Combining anatomical and functional analyses demonstrated to be a simple, yet powerful approach to detect patients at increased risk to develop pain from thalamic stroke. Both the morphological and the physiological techniques used here, including projection of MRI data onto a thalamic atlas, employed methods readily available, not needing complex equipment and that can be easily replicated by others. Anatomical (MRI) and functional indexes of spinothalamic involvement (thresholds, LEP) were independently and significantly associated with thalamic pain, and pointed to the STT lesion as a crucial element in the development of post-stroke thalamic pain. Their joint analysis proved superior to either of them alone to classify patients as ‘in-pain’ or ‘pain-free’. Conversely, although involvement of the principal somatosensory thalamic complex (VPL/VPM nuclei) and the presence of lemniscal symptoms were also extremely common in our patients, their incidence was not significantly different in patients with or without pain, and was not associated with pain development. All in all, our findings suggest that the main determinant of central pain after thalamic stroke was the injury to spinothalamic system within the posterior thalamus.
Pain was not included as an obligatory component of the thalamic syndrome when Dejerine and Roussy (1906) introduced the term. The core syndrome included mild hemiplegia, superficial hemianaesthesia, impaired deep sensation, hemiataxia and astereognosis, and in addition could produce ‘sharp, enduring, often intolerable pain’ (see Schott, 1995). The present results suggest that only when the thalamic lesion implies a significant alteration of the spinothalamic system are patients likely to develop thalamic
pain.
https://stroke.logicalmodel.net/flarum/public/assets/files/2025-02-24/1740392087-411142-thalamic-pain-anatomical-and-physiologic.pdf