Skip to main content
Log in

Aphasia and infarction of the posterior cerebral artery territory

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Spoken language disorders are rarely mentioned in superficial infarction of the posterior cerebral (PCA) territory. Two clinical types have been reported: transcortical sensory and amnesic aphasia. Between 1979 and 1990, we studied retrospectively 76 patients suffering from an occipitotemporal infarction located in the superficial territory of the posterior cerebral artery, all well documented by CT. Aphasia was one of the first and prominent signs in 18 cases. Middle cerebral artery concomitant infarction could have been the cause of language impairment in 10. In 8 patients aphasia was only explained by a PCA territory infarct. Three patients showed features of transcortical sensory aphasia. CT localization showed internal lobe and thalamic involvement of the dominant hemisphere. Five patients exhibited word finding impairment with various degrees of amnestic syndrome. The dominant internal temporal lobe was always afffected. Dominant thalamus involvement was found in one case only. Some correlations between clinical features and anatomical support (vascular supply and anatomical structure) might be suggested in our 8 cases of aphasic disorders due to PCA infarcts. They are discussed and compared with data in the literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Adams RD, Victor M (1989) Cerebrovascular disease. In: Adams RD, Victor M (eds) Principles of neurology. Mc Graw Hill, New York, p 632

    Google Scholar 

  2. Kinkel WR, Newmann RP, Jacobs L (1984) Posterior cerebral artery branch occlusions: CT and anatomic considerations: In: Bergner R, Bauer RB (eds) Vertebrobasilar arterial occlusive disease. Raven Press, New York, pp 117–133

    Google Scholar 

  3. Pessin MS, Lathi ES, Cohen MB, Kwan ES, Hedges TR, Caplan L (1987) Clinical features and mechanism of occipital infarction. Ann Neural 21:290–299

    Google Scholar 

  4. Chambers BR, Brooder RJ, Donnan GA (1991) Proximal posterior cerebral artery occlusion simulating middle cerebral artery occlusion. Neurology 41:385–390

    PubMed  Google Scholar 

  5. Hillemand P (1925) Contribution à l'étude des syndromes de la région thalamique. Thèse, Jouve, Paris

    Google Scholar 

  6. Fisher CM (1959) The pathologic and clinical spects of thalamic hemorrhage. Trans Am Neurol Assoc 84:56–59

    PubMed  Google Scholar 

  7. Alexander MP, Lo Verme SR (1980) Aphasia after left hemispheric intracerebral hemorrhage. Neurology 30:1193–1202

    PubMed  Google Scholar 

  8. Smyth GE, Sern K (1938) Tumours of the thalamus: a clinico-pathological study. Brain 61:339–374

    Google Scholar 

  9. Cheek WR, Taveras JM (1966) Thalamic tumors. J Neurosurg 24:505–513

    PubMed  Google Scholar 

  10. Selby G (1967) Stereotactic surgery for the relief of Parkinson's disease. An analysis of the results in a series of 303 patients. J Neurol Sci 5:343–373

    PubMed  Google Scholar 

  11. Bell DS (1968) Speech functions of the thalamus inferred from the effects of thalamotomy. Brain 91:619–639

    PubMed  Google Scholar 

  12. Guiot G, Hertzog E, Rondot P, Molina P (1961) Arrest or acceleration of speech evoked by thalamic stimulation in the course of stereotaxic procedure for parkinsonism. Brain 84:363

    PubMed  Google Scholar 

  13. Krayenbühl H, Siegfried J, Kohenof M, Yasargil MG (1965) Is there a dominant thalamus? Confin Neurol (Basel) 26:246–249

    Google Scholar 

  14. Ojemann GA, Fedeo P (1968) Effect of stimulation of the human thalamus and parietal and temporal white matter on short term memory. J Neurosurg 29:51–59

    PubMed  Google Scholar 

  15. Demeurisse G, Derouck M, Cockaerts MJ, Necle C van, Demol O, Capon A (1979) Study of two cases of aphasia by infarction of the left thalamus, with out cortical lesion. Acta Neurol Belg 79:450–459

    PubMed  Google Scholar 

  16. Cohen JA, Gelfer CF, Sweet RD (1980) Thalamic infarction producing aphasia. Mt Sinaï J Med 47:389–404

    Google Scholar 

  17. McFarling D, Rothi LJ, Heilman KM (1982) Transcortical aphasia from ischaemic infarcts of the thalamus: a report of two cases. J Neurol Neurosurg Psychiatry 45:107–112

    PubMed  Google Scholar 

  18. Graff-Radford NR, Eslinger PJ, Damasio AR, Yamada T (1984) Non hemorrhagic infarction of the thalamus: behavioral, anatomic, and physiologic correlates. Neurology 34:14–23

    PubMed  Google Scholar 

  19. Gorelick PB, Hier DB, Benevento L, Levitt S, Tan W (1984) Aphasia after left thalamic infarction. Arch Neurol 41:1296–1298

    PubMed  Google Scholar 

  20. Bogousslavsky J, Regli F, Uske A (1988) Thalamic infarcts: clinical syndromes, etiology, and prognosis. Neurology 38:837–848

    PubMed  Google Scholar 

  21. Matsui T, Hirano A (1978) An atlas of the human brain of computerized tomography. Igaku Skoin, Tokyo

    Google Scholar 

  22. Percheron G (1977) Les artères du thalamus humain. Artères et territoires thalamiques paramédians de l'artère basilaire communicante. Rev Nerol (Paris) 132:309–324

    Google Scholar 

  23. Percheron G (1977) Les artères du thalamus humain. Artère et branches thalamiques polaires des l'artère communicante postérieure et territoires thalamiques paramédians de l'artère communicante. Rev Neurol (Paris) 132:297–307

    Google Scholar 

  24. Benson DF, Geschwind N (1985) Aphasia and related disorders: a clinical approach. In: Mesulam MM (eds) Principles of behavioural neurology. Davis, Philadelphia, pp 193–238

    Google Scholar 

  25. Cummings JL, Benson DF, Hill MA, Read S (1985) Aphasia in dementia of the Alzheimer type. Neurology 35:394–397

    PubMed  Google Scholar 

  26. Kertesz A, Sheppard A, McEnzie R (1982) Localization in transcortical sensory aphasia. Arch Neurol 39:475–478

    PubMed  Google Scholar 

  27. Cappa SF, Vignolo LA (1979) “Transcortical” features of aphasia following left thalamic hemorrhage. Cortex 15:121–130

    PubMed  Google Scholar 

  28. Berthier ML, Starkstein SE, Leiguarda R, Ruiz A, Mayberg HS, Wagner H, Price TR, Robinson RG (1991) Transcortical aphasia: importance of the non speech dominant hemisphere in language repetition. Brain 114:1409–1427

    PubMed  Google Scholar 

  29. Lichteim L (1885) On aphasia. Brain 7:443–484

    Google Scholar 

  30. Wernicke C (1985–1986) Einige neuere Arbeiten über Aphasie. Fortschritte der Medizin, 3, 463. Translated in Wernicke's work on aphasia; Eggert GH (ed). Mouton, Paris, pp 173–205

    Google Scholar 

  31. Henschen SE (1920–1922) Klinische und anatomische Beiträge zur Pathologie des Gehirns. Stockholm Nordisk Bockhanbdeln vol 5–7

  32. Dejerine J (1914) Semeïologie des affections du système nerveux. Masson, Paris

    Google Scholar 

  33. Geschwind N, Quadfasel F, Segarra J (1968) Isolation of the speech area. Neurophsychologia 6:327–340

    Google Scholar 

  34. Withaker H (1976) A case of the isolation of the language function. In: Whitaker H, Whitaker HA (eds) Studies in neurolinguistics, vol 2. Academic Press, New York, pp 1–58

    Google Scholar 

  35. Graff-Radford NR, Damasio H, Yamada T (1985) Non haemorragic thalamic infarcts: clinical, neuropsychological and electrophysiological findings in four anatomical groups defined by computerized tomography. Brain 108:485–516

    PubMed  Google Scholar 

  36. Bogousslavsky J, Regli F, Assal G (1986) The syndrome of unilateral tuberothalarnic artery territory infarction. Stroke 17:434–441

    PubMed  Google Scholar 

  37. Cambier J, Graveleau P (1985) Thalamic syndromes. In: Vinken PJ, Bruyn GW, Klawans HL (eds) Handbook of clinical neurology, vol 1 (45), chapter 7. Elsevier, Amsterdam, pp 87–98

    Google Scholar 

  38. Puel M, Cardebat D, Demonet JF, Elghozi D, Cambier J, Guiraud-Chaumeil B, Rascol A (1987) Le rô1e du thalamus dans les aphasics sous corticales. Rev Neurol (Paris) 142:431–440

    Google Scholar 

  39. Coslett HB, Roeltgen DP, Gonzalez Rothi L, Heilman KM (1987) Transcortical sensory aphasia: evidence for subtypes. Brain Lang 32:362–378

    PubMed  Google Scholar 

  40. Botez MI, Barbeau A (1971) Role of subcortical structures, and particularly of the thalamus in the mechanisms of speech and language. Int J Neurol 8:300–320

    PubMed  Google Scholar 

  41. Crosson B (1985) Subcortical functions in language: a working model. Brain Lang 25:257–292

    PubMed  Google Scholar 

  42. Mohr JP (1986) Posterior cerebral artery. In: Barnett HJ, Mohr JP, Stein B, Yatsu F (eds) Stroke: pathophysiology, diagnosis and management. Livingstone, New York, pp 451–474

    Google Scholar 

  43. Nissl von Mayendorf E (1911) Die aphasischen Symptome und ihre corticale Lokalisation. Barth, Leipzig

    Google Scholar 

  44. Bando M, Ugawa Y, Sugishita (1986) Mechanism of repetition in transcortical sensory aphasia. J Neurol Neurosurg Psychiatry 47:200–202

    Google Scholar 

  45. Goldstein K (1915) Die transkortikalen aphasien. Fisher, Jena

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Servan, J., Verstichel, P., Catala, M. et al. Aphasia and infarction of the posterior cerebral artery territory. J Neurol 242, 87–92 (1995). https://doi.org/10.1007/BF00887822

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00887822

Key words

Navigation