Reynolds A F, Harris A B, Ojemann G A, Turner P T
J Neurosurg. 1978 Apr;48(4):570-4. doi: 10.3171/jns.1978.48.4.0570.
Left thalamic hemorrhage as a cause of aphasia has not been widely recognized. Large thalamic hemorrhages cause coma, making speech examination impossible; smaller thalamic hemorrhages were difficult to document until recent diagnostic advances. Nine cases of thalamic hemorrhage with aphasia have been described in the literature. This report presents four additional cases. These patients had acute onset of aphasia, supranuclear paralysis of upward gaze, right hemisensory deficits, and mild right hemiparesis. Three of the four patients responded to ventriculostomy drainage with rapid clearing of the supranuclear paralysis of upward gaze, and two later required placement of permanent ventricular shunts. After 1 year, two patients exhibited no clinically detectable speech malfunction and the other two were severely aphasic. The hemiparesis, hemisensory deficits, and ocular pareses all cleared. These cases are discussed with respect to present models of the role of the thalamus in speech.
左侧丘脑出血作为失语症的病因尚未得到广泛认可。大量丘脑出血会导致昏迷，使得言语检查无法进行；较小的丘脑出血在近期诊断技术取得进展之前难以记录。文献中已描述了9例伴有失语症的丘脑出血病例。本报告新增了4例。这些患者出现失语症急性发作、核上性向上凝视麻痹、右侧半身感觉障碍和轻度右侧偏瘫。4例患者中有3例对脑室造瘘引流有反应，核上性向上凝视麻痹迅速消除，2例随后需要放置永久性脑室分流管。1年后，2例患者未出现临床上可检测到的言语功能障碍，另外2例严重失语。偏瘫、半身感觉障碍和眼部麻痹均已消除。结合目前关于丘脑在言语中作用的模型对这些病例进行了讨论。
