The study analyses clinical presentation of language functions of 32 patients with subcortical aphasia induced by stroke. The patients have been divided into three groups according to neuroanatomic localization of the lesion, defined by CT and MRI examination (striato-capsular aphasia, aphasia associated with white matter paraventricular lesions and thalamic aphasia). The following batteries and tests were used: the neurologic examination, CT scan, MRI, Doppler ultrasound, Mini Mental State Examination, Boston Diagnostic Aphasia Examination (BDAE), Boston Naming Test (BNT), Token Test and Verbal Fluency Test. Clinical presentation of subcortical aphasias is characterized with preserved repetition, however, some groups differ by certain specific features of language impairment. Striato-capsular aphasia and aphasia associated with white matter paraventricular lesions are characterized with lack of speech fluency, occurrence of literary paraphasias, mainly preserved comprehension and naming. Thalamic aphasia, however, is characterized with fluent output, impaired comprehension and naming with predominant verbal paraphasias. The specific features of language impairment suggest that subcortical structures contribute to language organization. Considering the results of language tests we presume that the most prominent feature in striato-capsular aphasia is phonetic impairment of language, opposite to thalamic aphasia where lexical-sematic processing seems to be affected.

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The aim of this study was to investigate the characteristic symptom cluster and the course of aphasia in 12 patients with single left thalamic lesion verified by CAT scan. The testing of language disorder was performed by standard linguistic tests for aphasia in the acute stage and one month after the insult. Although this clinical syndrome varied greatly it was possible to point out some common characteristics. Spontaneous speech was fluent, easily articulated, grammatically correct, with preserved melodic line. Word finding and understanding were impaired. The impaired comprehension and naming were prominent in all patients with different severity. Repetition skills were intact. During the naming testing patients accomplished better results after semantic help than after phonetic help. Verbal paraphasia errors appeared more frequently (9.78) than neologistic (2.22) and literal paraphasias (1.78). Results of the language fluency tests were worse during semantic categorization tests (5.50) than during animal naming (9.89). On the basis of these facts it was presumed that aphasia in patients with dominant thalamic lesion was the result of lexicosemantic language disorder. It was statistically proved that recovery from aphasia in these cases tended to be significant and rapid.