Neuroanatomical considerations of isolated hearing loss in thalamic hemorrhage

Background and importance: Thalamic lesions are associated with a wide variety of clinical syndromes. Due to the close anatomic proximity of the nuclei, many of these syndromes have considerable overlap in clinical sequelae and, as such, a lesion affecting only one modality is exceedingly rare. Clinical presentation: In this case, a 55 year-old right handed man with a past medical history significant for hypertension, polysubstance abuse, and a 25 year history of seizure disorder following clipping of a middle cerebral artery aneurysm presented with isolated bilateral hearing loss. Conclusion: Presumably, this neurological deficit was caused by a hypertensive hemorrhage in the posterior right thalamus. The following case and discussion will review the potential neuroanatomical pathways that we suggest could make isolated hearing loss be part of a “thalamic syndrome.