You are here

  • Home
  • Archive
  • Volume 14, Issue 3
  • Bilateral thalamic lesion presenting as Broca’s type subcortical aphasia in cerebral venous thrombosis: index case report

Article Text

Article menu
Download PDFPDF
Case report
Bilateral thalamic lesion presenting as Broca’s type subcortical aphasia in cerebral venous thrombosis: index case report
  1. Shambaditya Das,
  2. Souvik Dubey,
  3. Alak Pandit and
  4. Biman Kanti Ray
  1. Neurology, Institute of Postgraduate Medical Education and Research, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
  1. Correspondence to Dr Souvik Dubey; drsouvik79{at}gmail.com

Abstract

A 35-year-old man with a history of multiple substances abuse (alcohol, tobacco and cannabis) presented with acute, severe, holocranial headache associated with nausea and few episodes of vomiting followed by acute onset Broca-type aphasia with intact comprehension from next day, without any other focal neurodeficits, seizure or altered sensorium. Neurological examination was marked by Broca-type aphasia and failure in convergence reaction bilaterally, rest unremarkable. Brain imaging revealed lesions in bilateral thalamus, while magnetic resonance venography showed multiple flow voids in posterior part of superior sagittal sinus and bilateral transverse sinus. A diagnosis of cerebral venous sinus thrombosis was made. Subsequent investigations revealed decreased levels of protein C, protein S and antithrombin III. The patient was started on anticoagulation to which his headache and aphasia recovered completely after 8 and 12 days of therapy, respectively. He is being continued on anticoagulation and is following-up with us for past 4 months uneventfully.

  • stroke
  • neuroimaging
  • warfarin therapy
  • venous thromboembolism

https://doi.org/10.1136/bcr-2020-240196

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors SDa prepared the manuscript and collected all relevant data and investigations, edited the manuscript further and was involved directly in patient care. SDu gave expert opinion regarding the case, edited the manuscript, gave critical revision of the content and final approval and supervised the entire attempt of case report. AP gave expert opinion about the case and gave critical revision of content and final approval. BKR supervised the treatment, and gave expert opinion about the case and gave critical revision of content and final approval. All authors are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.