Acute mixed transcortical aphasia following an infarction in the left putamen

Mixed transcortical aphasia is an uncommon occurrence with acute stroke. A 62 year old female is described with mixed transcortical aphasia and right hemiparesis and occlusion of the left internal carotid artery. The CT scan of the brain showed an infarction in the left putamen indicating that there is more than one anatomic possibility underlying mixed transcortical aphasia. Infarction of the putamen alone is rare. The mechanism is discussed and it is postulated that a subcortical lesion suitably placed could singularly disrupt the neural pathways to give rise to mixed transcortical aphasia.