Acquired aphasia in children after surgical resection of left‐thalamic tumors

Abstract

Five children (three males, two females; four right‐, one left‐handed; age range 6 to 14 years) who developed aphasia after gross‐total excision of left predominantly thalamic tumors are reported. Three patients had Broca aphasia, one had mixed transcortical aphasia, and one patient had conduction aphasia. In the months after surgery, three children improved while receiving radiation and/or chemotherapy, although none recovered completely. Two patients with malignant tumors developed worsening aphasia when the tumor recurred, and later died. Two of three patients tested had visuospatial difficulties in addition to language deficits. Attention and executive functioning were affected in three of three patients tested. Memory, verbal and/or visual functioning, were affected in four of four patients tested. Both patients who were tested showed transient right hemineglect. Two of two patients tested were probably apraxic. The wide range of deficits in these children highlights the importance of the thalamus and other subcortical structures in developing cognition.

Aphasia Owing to Subcortical Brain Infarcts in Childhood

“…Dynamic studies after subcortical or thalamic insult in adults, showing cortical hypometabolism, suggest that the basal ganglia could be an integrator of language functions via verbal memory or semantic mechanism and could be an activator of cortical language functions. 25 To conclude, our observations, supported by those of others, stress the importance of the basal gray nuclei and the adjacent white-matter pathways in the development and use of oral and written language. In children, these subcortical neuronal centers and fiber pathways appear to be implicated particularly in the expression of speech, especially in vocabulary access and storage.…”

“…Acquired aphasia in children was also described after surgical resection of left thalamic tumors 25 ; localizations were not strictly identical, and the profile of aphasia was close but more heterogeneous: three patients had Broca aphasia, one had mixed transcortical aphasia, and one had conduction aphasia.…”

Disconnection syndromes of basal ganglia, thalamus, and cerebrocerebellar systems

“…In the first detailed account of the behavioral consequences of thalamic hemorrhage, Fisher (1959) described neglect ("modified anosognosia and hemiasomatognosia"), global "dysphasia", confusion and visual hallucinations. Accounts followed of thalamic dementia from prion diseases (Martin, 1997), and behavioral changes in patients with thalamic tumors (Ziegler et al, 1977;Nass et al, 2000), but these lesions are seldom confined to thalamus. There are four thalamic vascular syndromes that illustrate the behavioral roles of the thalamic nuclei (Schmahmann, 2003) (Table 2; Fig.…”

Pathophysiology of language switching and mixing in an early bilingual child with subcortical aphasia

“…While subcortical aphasia has been extensively studied in adults with vascular lesions (for a review see Cappa and Abutalebi, 1999), only a few childhood cases have been reported (Ferro et al, 1982;Aram et al, 1983;Cranberg et al, 1987;Van Lieshout et al, 1990;Martins et al, 1993;Garg and DeMyer, 1995;Kieffer-Renauz et al, 1996;Nass et al, 2000). In further contrast to a long-standing tradition in the study of adult aphasia, the literature is sparse with regard to bilingual or polyglot aphasia in children (Bouquet et al, 1981;Fabbro and Paradis, 1995).…”