Aphasia does not always follow left thalamic hemorrhage: a study of five negative cases

Five right-handed patients suffering from a recent CT-assessed left posterior thalamic hemorrhage are reported. In all patients a standard language examination performed within one month after stroke onset did not reveal aphasic disturbances. While the present series argues for the role of intrathalamic lesion localization, a review of the literature suggests that lesion site per se does not always account for the presence or absence of aphasia in the individual case. The importance of reduced blood flow and metabolism in cortical areas which appear undamaged on CT scan is briefly discussed.