A study of aphasia caused by putaminal hemorrhage

Aphasia was evaluated in 21 right-handed patients (39-74 years old) with putaminal hemorrhage, and compared with that caused by thalamic hemorrhage. The patients were divided into three groups by the volume of the hematoma: small hematoma (I, n = 6), middle hematoma (II, n = 8) and large hematoma (III, n = 7) groups in computed tomographic findings. Aphasia examination was performed 8-37 days (mean 21 days) after the onset. In group I, aphasia was not seen or just transient, if any. In group II, aphasia was mainly a mixed type, and the prognosis was excellent in many patients. In group III there were expressive type at anterior lesion, receptive type at posterior lesion and global aphasia at anterior-posterior lesion, and the prognosis was not good. It is suggested that the putamen itself does not participate in language behavior, and that aphasia caused by putaminal hemorrhage is due to destruction of the surrounding tissue of the putamen. The type of aphasia and prognosis are varied by the site of a lesion and a hematoma volume. It is also suggested that the thalamus is related to language behavior in a circle of thalamus-cortical language area-thalamus. Aphasia caused by putaminal or thalamic hemorrhage was observed to be different from classical cortical aphasia. But there was no significant difference between aphasia caused by putaminal lesions and that by thalamic lesions.