Afasia talámica en glioma: Reporte de caso y revisión de la literatura

Abstract

Introduction: Thalamic aphasia is a rare language disorder primarily associated with vascular lesions, although it may also occur in the context of tumors. Its clinical recognition is challenging due to the heterogeneity of its presentation and the involvement of the thalamus in multiple higher-order functions. Case report: We present the case of a 38-year-old woman with severe headache and progressive hemiplegia in whom an intra-axial expansile lesion in the left thalamus, consistent with a high-grade glioma, was identified. The patient presented with anomia, semantic paraphasias, and impaired performance on verbal fluency tests. Advanced neuroimaging studies, including multimodal magnetic resonance imaging and tractography, confirmed a mass effect without significant disruption of language-related fiber tracts. Neuropsychological assessment revealed impairment of semantic, phonological, and executive language processes. Discussion: This case highlights the role of the thalamus as a critical structure within language networks, even when the classical cortical pathways remain intact. Clinical, neuroimaging, and neuropsychological correlations provide evidence of the functional impact of thalamic tumors on the executive organization of language. Conclusion: Thalamic aphasia secondary to glioma represents a diagnostic and therapeutic challenge. Integrating advanced neuroimaging with cognitive assessment allows for a more precise characterization of deficits and contributes to the development of individualized interventions. This report underscores the need for further research into the role of the thalamus in language processing and other higher-order functions.