Agrammatic speech production after a right cerebellar haemorrhage

Abstract We report the case of a patient who developed a severe expressive agrammatic disorder, mainly characterized by the omission of function words, after a haemorrhagic stroke involving the right cerebellar hemisphere. A detailed analysis of syntactic and morphological abilities confirmed that the disorder was limited to spontaneous production, and was much less evident in recitation of well known dramatic pieces (the patient was a professional actor). The speech disorder recovered in about 2 months. The presence of crossed frontal diaschisis on a SPECT scan performed in the acute stage and its regression after recovery suggest that interference within a complex cerebellar basal ganglia-frontal cortex loop may be responsible for this unusual speech disorder.