APHASIA FROM AN INFARCT IN THE LEFT PARAMEDIAN THALAMIC REGION - CLINICAL AND PATHOLOGIC FINDINGS IN ONE CASE

  • 1 January 1984
    • journal article
    • research article
    • Vol. 140  (12) , 711-719
Abstract
A 67 yr-old right-handed man presented with an aphasia of acute onset associated to paralysis of vertical eye movements, mild cerebellar right dysmetria and right hemiparesis without hemianopsia. CT [computed tomography] scan showed 2 low density areas in the left thalamus and left occipital lobe. Neuropsychological examination revealed a nonfluent aphasia with normal repetition, semantic paraphasias and a good comprehension of verbal and written commands. There was no alexia. Writing was impaired only by motor disturbances. Tetraparesis and impairment of consciousness followed by a locked in syndrome supervened 3 wk after the onset. Death occurred 4 mo. after onset. Neuropathological exaination showed a left paramedian thalamic infarct involving the ventrolateral, dorso-medial and intralaminar nuclei, sparing the pulvinar. There was an occipital infarct sparing the calcarine scissure and multiple infarctions in the pons and the cerebellum. Broca''s and Wernicke''s areas were spared. The involvement of medial nuclei could be partly responsible of language disturbances in thalamic aphasia.