Bilateral Gustatory Disturbance Associated With Unilateral Putaminal Hemorrhage: A Case Report and Literature Review.

Taste disturbance is relatively common after acute stroke but is often overlooked because it is subjective and frequently overshadowed by more prominent neurological deficits. Gustatory dysfunction specifically associated with putaminal hemorrhage has rarely been reported. We describe a 43-year-old right-handed woman who developed acute bilateral loss of taste in close temporal association with a left putaminal hemorrhage, despite clinically preserved olfaction and only mild sensory symptoms. Brain magnetic resonance imaging demonstrated a small left putaminal hemorrhage with surrounding edema extending toward the thalamic region. Electrogustometry performed on hospital day 11, after partial subjective improvement, revealed bilateral but asymmetric gustatory impairment. Alternative causes, including peripheral cranial nerve dysfunction, medication-induced dysgeusia, postinfectious etiologies, and metabolic abnormalities, were considered less likely based on the clinical course and diagnostic evaluation. Her taste disturbance gradually improved and was completely resolved within two months. In this patient, the temporal association and imaging findings suggest, but do not prove, transient dysfunction of adjacent subcortical gustatory pathways, including thalamocortical projections or fibers near the internal capsule. Gustatory disturbance after putaminal hemorrhage is rarely reported and may be underrecognized in routine stroke assessment. Targeted inquiry regarding taste perception and, when available, objective gustatory testing may improve detection and characterization of this subtle manifestation in patients with deep hemispheric stroke.