A Case of Transcortical Sensory-like Aphasia Due to a Pulvinar Lesion on MRI
Ryan Skowronek1, Joseph Pysh2
1Michigan State University Department of Neurology and Ophthalmology / Sparrow Hospital, 2Michigan State University Department of Neurology and Ophthalmology
Objective:
The objective is to describe an uncommon case of a patient who presented with the diagnosis of transcortical sensory aphasia and unexpectedly had a small acute ischemic lesion of the left pulvinar nucleus rather than the more typical involvement of the left parietal or temporal lobes.
Background:
A middle-aged right-handed male was found down after an unknown length of time and was brought in for confusion. On examination, he exhibited impaired comprehension, dysnomia, and frequent semantic and neologistic paraphasic errors but intact fluency and repetition.
Results:
MRI brain without contrast revealed a small discrete posterior thalamic infarct. Throughout his admission, his aphasia gradually improved but did not completely resolve, with the patient exhibiting residual dysnomia at discharge. Based on the research spearheaded by Bruce Crosson, this poster will review the literature outlining the role of the pulvinar nucleus in language processing, why these lesions manifest with word-finding difficulties, and the significance of adding this case to the collection of clinical data.
Conclusions:
The typical presentation of aphasia is associated with cerebral cortical lesions. While thalamic aphasia has been known for some time, it is not universally recognized by all clinicians. In this case, we call attention to the entity of pulvinar aphasia and the importance of subcortical imaging for atypical cases of aphasia.