title: Agraphia caused by left thalamic hemorrhage.
abstract: A 71-year-old right-handed man was admitted to our hospital with right hemiparesis and sensory impairment associated with mild aphasia. Although aphasia gradually resolved within 2 weeks after stroke onset, his writing ability remained disturbed. A computed tomography (CT) scan at stroke onset revealed a hematoma in the left thalamus, but no cortical lesions were observed. Further, a single-photon emission CT (SPECT) scan showed decreased blood flow in the left thalamus, in the cortical region extending from the left superior temporal gyrus to the parietal lobe, and in the frontal lobe. It is possible that agraphia may have directly resulted from the thalamic lesion, but SPECT findings strongly suggested that a general decrease in left cortical function concomitant with a disruption of the thalamocortical and cortico-thalamocortical projection fibers produced these cognitive deficits.
authors.affiliation: Department of Rehabilitation Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Osawa
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Maeshima
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Yamane
authors.forename: Nahoko
authors.initials: N
authors.lastname: Uemiya
authors.forename: Ikuo
authors.initials: I
authors.lastname: Ochiai
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yoshihara
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Ishihara
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
keywords: Agraphia; Aphasia; Cerebral hemorrhage; Stroke