A 72 year-old woman was found to have hemorrhage limited to the head of the left caudate nucleus. Clinical symptomatology consisted of disturbances in oral, written, and graphic expression. There were no difficulties in comprehension, dysarthria, or phonemic paraphrasing, but speech and graphic expression were incoherent. Perseverance of ideas, semantic inconsistencies, inability to keep a stable objective during speech and graphic activity, are the principal characteristics of a disorder which is related to a prelinguistic stage, and illustrate the role of the caudate nucleus in the selection processes which are a preliminary step for speech organization.