[Aphasia of deep localization]

A neurolinguistic and cerebral computed tomography (CT) study was carried out in 60 patients with aphasia. Fourteen had predominant subcortical involvement. Six of these showed involvement of the basal ganglia (5 with thalamic involvement), with small mass effect and small volume (less than 5 ml). The type of aphasia in this group was not uniform; it was remarkable, however, that initially there was mutism or initially non fluid language which soon became fluid in one half of the patients. Repetition and partially or totally preserved comprehension, together with dysarthic, dysprosodic and hypophonic abnormalities, were very common. The latter even had a more prolonged course than aphasic abnormalities. All the lesions in the remaining 8 patients had greater volume and were paracapsular in topography; 5 patients behaved as global aphasia (with a mean calculated volume of 23.7 ml), and the remaining 3 showed fluid aphasia, with an intermediate size (15 ml).