Conclusions: Although an uncommon finding, occult tethered cord should still be considered in the differential of patients presenting with new onset neurogenic bowel and bladder.
We present two cases of thalamic infarction presentation with aphasia, which has rarely been documented in the literature. Of interest, the second case presented with a lesion in the non-dominant thalamus, which made the finding of speech impairment exceedingly rare. Anomic aphasia has been associated with lesions to the basal temporal lobe, anterior inferior temporal lobe, temporo-parieto-occipital junction and the inferior parietal lobe, but rarely in association with the thalamus. Thalamic strokes most often present with motor, sensory, and cognitive deficits; few reports in the medical literature associate aphasia with a thalamic infarction. Possible explanations include crossed aphasia, diaschisis, the hypometabolic theory, and the thalamus as a secondary language center. Our findings may hint to a relationship among language, higher cognitive function, subcortical structures, and interhemispheric connections that are yet to be understood completely. We postulate that an increasingly important role of subcortical neuronal structures in cognitive functions will be recognized as diagnostic imaging technology improves over time.
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