title: Crossed aphasia and visuo-spatial neglect following a right thalamic stroke: a case study and review of the literature.
abstract: Crossed aphasia in dextrals (CAD) following pure subcortical lesions is rare. This study describes a right-handed patient with an ischemic lesion in the right thalamus. In the post-acute phase of the stroke, a unique combination of 'crossed thalamic aphasia' was found with left visuo-spatial neglect and constructional apraxia. On the basis of the criteria used in Mariën et al. [67], this case-report is the first reliable representative of vascular CAD following an isolated lesion in the right thalamus. Furthermore, this paper presents a detailed analysis of linguistic and cognitive impairments of 'possible' and 'reliable' subcortical CAD-cases published since 1975. Out of 25 patients with a pure subcortical lesion, nine cases were considered as 'possibly reliable or reliable'. A review of these cases reveals that: 1) demographic data are consistent with the general findings for the entire group of vascular CAD, 2) the neurolinguistic findings do not support the data in the general CAD-population with regard to a) the high prevalence of transcortical aphasia and b) the tendency towards a copresence of an oral versus written language dissociation and a 'mirror-image' lesion-aphasia profile, 3) subcortical CAD is not a transient phenomenon, 4) the lesion-aphasia correlations are not congruent with the high incidence of anomalous cases in the general CAD-population, 5) neuropsychological impairments may accompany subcortical CAD.
authors.affiliation: Department of Linguistics, Vrije Universtiteit Brussel, Brussel, Belgium.
authors.forename: Lieve
authors.initials: L
authors.lastname: De Witte
authors.forename: Jo
authors.initials: J
authors.lastname: Verhoeven
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Engelborghs
authors.forename: Peter P
authors.initials: PP
authors.lastname: De Deyn
authors.forename: Peter
authors.initials: P
authors.lastname: Mariën
mesh_terms: D000368:Aged; D001037:Aphasia / Q000209:etiology / Q000473:pathology*; D007839:Functional Laterality; D006801:Humans; D007807:Language Tests; D008297:Male; D010468:Perceptual Disorders / Q000209:etiology / Q000473:pathology*; D011578:Psycholinguistics; D013028:Space Perception; D020521:Stroke / Q000150:complications / Q000473:pathology*; D013788:Thalamus / Q000473:pathology*; D014796:Visual Perception