Thalamic alexia with agraphia

Abstract

Alexia with agraphia is defined as an acquired impairment affecting reading and writing ability. It can be associated with aphasia but can also occur as an isolated entity. This impairment has classically been associated with a left angular gyrus lesion In the present study we describe a case involving a patient who developed alexia with agraphia and other cognitive deficits after a thalamic hemorrhage. In addition we discuss potential mechanisms of this cortical dysfunction syndrome caused by subcortical injury. We examined a patient who presented with alexia with agraphia and other cognitive deficits due to a hemorrhage in the left thalamus. Neuropsychological evaluation showed attention executive function arithmetic and memory impairments. In addition language tests revealed severe alexia with agraphia in the absence of aphasia. Imaging studies disclosed an old thalamic hemorrhage involving the anterior dorsomedial and pulvinar nuclei. Tractography revealed asymmetric thalamocortical radiations in the parietal region (left