Thalamic lesions may induce a diffuse hypometabolism and subsequent decrease of cortical cerebral blood flow (rCBF) and cerebral blood volume (rCBV). Up to now PET was used to assess these changes. However this latter method cannot be applied routinely to stroke patients because it is expensive and not currently available. The purpose of this preliminary study was to evaluate the effects of 'pure metabolic depression' induced by thalamic stroke on rCBV and rCBF by using a non invasive method perfusion-MRI. Two patients experienced aphasia, with motor and sensory impairment related to thalamic hemorrhage. Four weeks later, dynamic T2*-weighted echo planar imaging was used to produce perfusion-MR images during an intravenous bolus injection of gadopentetate dimeglumine. A decrease of cortical rCBV and rCBF mainly confined to sensorimotor cortex was observed in both cases ipsilateral to the lesion. Although a sequential assessment of this abnormalities is needed in a larger series of patients in order to establish relevant correlations with neurological status, this preliminary study indicates that perfusion-MRI might be a practical and promising tool in the assessment of cortical rCBV and rCBF changes.