Crossed right hemisphere syndrome following left thalamic stroke

In most right-handed people, language and motor functions are more reliant on systems of the left hemisphere while several non-linguistic visuo-spatial and attentional processes depend more on the right hemisphere. The rare exceptions to these rules provide important clues as to what functions co-lateralise, and are thus crucial for models of cerebral specialization. Here we report on the case of a patient, who, after a lesion restricted to the left thalamic region, showed signs normally associated with right hemispheric injury including motor impersistence, visuo-spatial dysfunction and poor comprehension of facial expression. Language abilities were spared and no signs of apraxia were present, in spite of his right hand, foot and eye preference, a pattern normally associated with conventional cerebral dominance. In spite of his other right hemispheric signs, the patient showed no signs of hemi-spatial neglect. The patient's pattern of spared and impaired abilities is compared and contrasted with other rare cases of crossed right hemisphere syndrome.