Persistent Aphasia Following a Purely Subcortical Lesion - a Magnetic-Resonance-Imaging Study

The case is presented of a 65-year-old man who developed a significant and persistent aphasia subsequent to a cerebrovascular accident involving the straito-capsular region. The findings of a neuroradiological examination and a series of language tests are described. Both computed tomography and magnetic resonance imaging demonstrated the presence of a large subcortical infarct centred on the region of the left basal ganglia and internal capsule and involving the white matter adjacent to the body of the left lateral ventricle. Neither imaging technique showed extension of the lesion to involve the cerebral cortex. Possible mechanisms whereby subcortical infarcts can cause language problems are discussed