Clinicoanatomical correlation in stroke related aphasia

Abstract

Context:With advances in neuroimaging, traditional views regarding the clinicoanatomic correlation in stroke patients with aphasia are being challenged and it has been observed that lesions at a given cortical or subcortical site may manifest with different aphasia profiles.Aims:To study as to whether there is a strict clinicoanatomical correlation between the type of aphasia and lesion site in patients with first ever stroke.Settings and Design:Observational study, based in a tertiary care center.Materials and Methods:Stroke patient's ≥18 years of age were screened and those with first ever stroke and aphasia were subjected to a detailed stroke workup and language assessment using the Hindi version of Western Aphasia Battery (WAB). Statistical analysis was done with χ2 test with Yates correction and Kruskal-Wallis test. The level of significance was set at P < 0.05.Results:Overall aphasia was detected in 27.9% of the 260 screened cases with stroke. Amongst 60 cases with first ever stroke and aphasia, the aphasia type was: Global (33.33%), Broca's (28.3%), transcortical motor (13.33%), transcortical sensory (10%), Wernicke's (8.33%), anomic (5%), and conduction (1.67%) aphasia. A definite correlation between the lesion site and the type of aphasia as per the traditional classification was observed in 35% cases only.Conclusions:No absolute correlation exists between the lesion site and the type of clinical aphasia syndrome in majority of the patients with cortical and subcortical stroke.

A hospital-based study of post-stroke aphasia: frequency, risk factors, and topographic representation

“…Both conductive and nominal aphasia were uncommon and were found in only 8.3% and 2.8% respectively. Our results are similar to many other studies which found that both global and motor aphasia are the major subtypes [30,[37][38][39].…”

Kejadian Afasia Pada Stroke Fase Akut Dan Perubahan Sindrom Afasia Pascastroke

“…5 Penelitian menunjukkan angka kejadian afasia pada stroke yang cukup tinggi, yaitu 13-40%. [6][7][8] Pemulihan afasia dapat terjadi secara bertahap dalam beberapa bulan pertama pascastroke. Menurut Watilla dkk pemulihan afasia sulit diprediksi karena banyak faktor yang memengaruhi proses pemulihan tersebut.…”

“…Beberapa penelitian afasia menunjukkan tidak terdapat perbedaan insidens afasia antara jenis kelamin. 6,13 Kardioemboli merupakan penyebab terbanyak afasia pada stroke iskemik dalam penelitian ini. Hal ini terjadi karena emboli otak yang bersumber dari jantung sering kali berukuran besar, sehingga dapat menyebabkan gejala stroke lebih berat.…”

“…Hal ini sesuai dengan data dalam penelitian lain yang menunjukkan angka kejadian afasia pada stroke 13-40%. [6][7][8] Sindrom afasia terbanyak pada stroke fase akut penelitian ini adalah afasia global diikuti afasia Broca. Bohra dkk pada tahun 2015 juga mendapatkan sindrom afasia terbanyak yaitu afasia global diikuti afasia Broca.…”

“…Bohra dkk pada tahun 2015 juga mendapatkan sindrom afasia terbanyak yaitu afasia global diikuti afasia Broca. 6 Penelitian ini menunjukkan 40% subjek afasia mengalami perubahan sindrom dalam 1 bulan pascaawitan. Lebih dari setengah subjek dengan afasia global berubah menjadi afasia Broca dan transkortikal motorik.…”