Presentation
The Patient was admitted to the emergency room for the sudden onset of anomic aphasia with right hemiparesis for 2 hours. NIHSS 14.
Patient Data
CT images show no hemorrhage and no ischemic brain lesion. AngioCT (not shown) doesn't show arterial stenosis or occlusion.
Symptoms completely resolved after the CT. 4 hours later, the same symptoms occurred (anomic aphasia with right hemiparesis) and another CT scan was performed. CT was negative, thus MRI was performed.
MR images show a left anterior thalamocapsular area with restricted diffusion with corresponding FLAIR signal abnormality. These findings were consisting with acute ischemic stroke without FLAIR/DWI mismatch.
Case Discussion
Left thalamic ischemic stroke can result in aphasia that is characterized by lexical-semantic deficits and intact word repetition, while fluency and comprehension are variably affected (thalamic aphasia) 1.
Disconnection between cortical language centers and thalamic nuclei is hypothesized to underlie these symptoms 1.
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