Affiliations: Department of Linguistics, Vrije Universtiteit
Brussel, Brussel, Belgium | Department of Communication Sciences, City University,
London, UK | Institute of Behavioural Neuroscience, Antwerp,
Belgium | Department of Neurology and Memory Clinic, Middelheim
General Hospital (ZNA), Antwerp, Belgium | Laboratory of Neurochemistry and Behavior, Institute
Born-Bunge Foundation, University of Antwerp, Antwerp, Belgium | Department of Health Care Sciences, University College
Antwerp, Antwerp, Belgium | Department of Nursing Sciences, Faculty of Medicine,
University of Antwerp, Antwerp, Belgium
Note: [] Corresponding author: Prof Dr. P. Mariën, ZNA-Middelheim
General Hospital, Department of Neurology, Lindendreef 1, 2020 Antwerp,
Belgium. Tel.: +32 3 2803136; E-mail: peter.marien5@telenet.be
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.
Keywords: Crossed aphasia, subcortical to aphasia, thalamus, right hemisphere, visuospatial neglect, stroke
