BrainWaves #118 Subcortical kinds of cortical signs

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: August 16, 2018Lesion localization is a critical skill for any neurologist. The so-called "cortical signs" are symptoms or examination findings, which are often associated with cortical neuron injury--aphasia, neglect, gaze preference. But they are also seen after injury to subcortical structures, including white matter tracts, the thalamus, and basal ganglia. In this week's installment of the BrainWaves podcast, we'll attempt to localize subcortical lesions based on these major cortical signs. Produced by James E Siegler. Music by Aussenseiter, Gnagno, Yshwa, and Kevin McLeod. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. REFERENCES Bogousslavsky J, Regli F, Uske A. Thalamic infarcts: clinical syndromes, etiology, and prognosis. Neurology 1988;38(6):837-48. Erratum in: Neurology 1988;38(8):1335. PMID 3368064 Fridriksson J, den Ouden DB, Hillis AE, et al. Anatomy of aphasia revisited. Brain 2018;141(3):848-62. PMID 29360947 Karnath HO, Himmelbach M, Rorden C. The subcortical anatomy of human spatial neglect: putamen, caudate nucleus and pulvinar. Brain 2002;125(Pt 2):350-60. PMID 11844735 Lam YW, Sherman SM. Functional organization of the thalamic input to the thalamic reticular nucleus. J Neurosci 2011;31(18):6791-9. PMID 21543609 Maeshima S, Osawa A. Thalamic lesions and aphasia or neglect. Curr Neurol Neurosci Rep 2018;18(7):39. PMID 29789957 Nadeau SE, Crosson B. Subcortical aphasia. Brain Lang 1997;58(3):355-402; discussion 418-23. PMID 9222518 Tijssen CC. Contralateral conjugate eye deviation in acute supratentorial lesions. Stroke 1994;25(7):1516-9. PMID 8023372  We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.