In vascular hemiplegia, motricity of the upper and lower limbs can be assessed from the examination of a limited number of movements which have been selected by a statistical procedure. For these movements the scores may be weighted on the basis of progress achieved over 2, 4 and 6 months. From the weighted, summed and averaged scores, a motricity index may be derived. This index gives a rapid overall indication of a patient’s progress in motor recovery, permits comparisons between different patients and the establishment of correlations with other clinical data and the values obtained by paraclinical techniques.

We present two patients with bilateral lesions of the superior temporal cortex who manifested a number of functional dissociations in the auditory domain. The perception of speech and environmental sounds were preserved; yet, the perception of tunes, prosody and voice was impaired. As the processing of melodic but not rhythmic variations in musical sequences was selectively disturbed, the deficit cannot be attributed to a general impairment in auditory memory or sequential processing. These findings suggest that melody processing is not mediated by a general-purpose auditory architecture but by specialized cortical subsystems residing within the lesioned areas. Current taxonomies of auditory agnosia and models of normal music cognition are evaluated in light of the functional dissociations manifested by these patients.

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 ...

Background and Purpose: Seasonal variation in the incidence of cerebral hemorrhage has been previously demonstrated. In this study, we sought to identify the climatological data best correlated with this seasonal variation.Methods: In a retrospectively studied sequential series of 236 patients with nontraumatic cerebral hemorrhage observed in Brussels over a period of 8 years, we cumulatively grouped the dates of stroke occurrence into a single calendar year.Results: We found marked seasonal variation in incidence, with the highest value (23%) observed in November-December and the lowest (10%) in July-August Seasonal variations in incidence of cerebral hemorrhage were shown to be correlated not only with the inverse of ambient temperature, but also with the inverse of hours of sunshine and with ambient humidity. We found no difference between hypertensive and normotensive patients.Conclusions: Our study fails to bear out the hypothesis that the higher incidence of cerebral hemorrhage in late autumn and winter is due to the influence of low ambient temperature on blood pressure. (Stroke 1992^3:24-27)

Several neurophysiological studies have highlighted the role of the midbrain periaqueductal gray matter (PAG) in the initiation of vocalization in various animal species, from frogs to primates. With regard to humans, only two cases of complete mutism following a lesion to the PAG have been reported so far. This article describes a new case of a patient (GM) who, following an ischemic lesion to the periaqueductal gray region of the midbrain, presented with complete and irreversible mutism, though her language comprehension functions and her non-verbal expression capacity were preserved. This clinical case provides evidence that in humans the PAG also acts as a link between different vocalization-eliciting external and internal stimuli (which reach the PAG from sensory and emotional structures) and the vocal-motor coordinating mechanisms in the lower brain stem.