Quantitative study of the rate of recovery from aphasia due to ischemic stroke.

Abstract

DETECTION OF CEREBROVASCULAR DISEASE/flue// et al. 455may be used to detect and quantify intracranial flow abnormalities. RGA is then employed if there are still unanswered questions or when a patient's clinical presentation, DS or RNA findings indicate need for surgery. SUMMARY The extent of recovery from aphasia following ischemic stroke has been evaluated by a quantitative method. The greatest improvement was observed during the first 3 months following onset. The rate of recovery was similar for expression and for comprehension, but comprehension was usually less disturbed than expression. Final prognosis depends on the type of aphasia (the poorest prognosis was found for total or global aphasia) and on the severity of the initial insult. Stroke, Vol 11, No 5, 1980 ASSESSMENT of the rate of recovery is important in the study and management of aphasia. The rate of recovery in a population of patients with stroke was studied with particular attention to the correct patient classification and to a precise quantification of the disorders. Patients and MethodsSeventy-five patients with aphasia following stroke were studied (mean age 67 years). There were 34 males aged 53 to 85 years (mean 66) and 41 females aged 27 to 88 years (mean 68).All patients had a cerebral infarction (none had hemorrhage); all were right-handed (handedness determined according to Bryden 1 ); all had an infarction in the left hemisphere as determined by EEG, Mm Tc pertechnetate scan and, in some, by angiography and CT scan. Nine patients were classified as having total or global aphasia, 46 Broca's aphasia and 20 Wernicke's aphasia. Patients with anomic aphasia, conduction aphasia or agrammatism were infrequently found and were not included in the study.Classification of aphasia was based on verbal expression. In the patients classified as having Broca's aphasia, verbal expression was initially characterized by mutism or speech limited to one or more syllables, one or more words always the same, or by sentences involving the following abnormalities: omission of words, dysarthria, perseveration, paraphasia, iteration (repetition of a phoneme, a syllable, or a word, without completion of the message), palilalia (repetition of words, phrases or sentences, with completion of the message), echolalia, agrammatism, dyssyntaxia. In the patients believed to have Wernicke's aphasia, neologisms were present as well as phonemic deformations, indeterminate, semantic and morphological paraphasias, dyssyntaxia, leading to a dysphonemic (predominance of phonemic errors), dysseman- tic (predominance of paraphasias) or mixed jargon. Total or global aphasia was diagnosed when language was initially characterized by the absence of comprehension and by mutism or when verbal expression was limited to a few sterotyped sounds. Disorders of verbal comprehension and expression were analyzed separately. Both were studied during spontaneous speech and during a set of special tests. 1For spontaneous speech, the severity of comprehension impairment was assessed on ...

Auditory Discrimination After Left-Hemisphere Stroke

“…Several previous studies with various language tests also suggest that the recovery of language functions is the most rapid during 3 months after stroke. [33][34][35][36] The most dramatic MMN amplitude changes also occurred by the 3-month measurement. Furthermore, there was a significant correlation between the changes in BDAE percentiles and the duration MMN amplitudes from the 10-day to the 3 months measurement.…”

“…At the acute stage, MMN was diminished in amplitude, especially for right-ear stimulation. Three months after stroke, by which time the most active, spontaneous recovery should occur, [33][34][35][36] MMN had dramatically increased, especially for the right-ear duration change.…”

The profile of recovery from stroke and factors influencing outcome.

“…This is in agreement with the findings of Demeurisse. 20 Most earlier studies have stressed the importance of the usual neurological findings, e.g. hemiparesis, dysphasia etc., while neuropsychological disturbances have received less attention.…”

Prediction of Aphasia Outcome Using Diffusion Tensor Tractography for Arcuate Fasciculus in Stroke

“…17 It was performed at an early stage of stroke (mean, 20.6 days after onset; range, 10 -30 days) and approximately 6 months after onset (mean follow-up period, 171.5 days after onset; range, 93-354 days; 93-180 days, 14 patients; 180 -270 days, 9 patients; 270 -354 days, 2 patients) because most recovery has been known to be achieved during the first 3-6 months after onset. [18][19][20][21][22] Both the reliability and validity of the K-WAB have been well established previously.…”