Verbal language spontaneous recovery after ischemic stroke

Abstract

-Objective: To analyze the spontaneous recovery of the verbal language on patients who have had an ischemic stroke. Method: Retrospective analysis of 513 medical records. We characterize referring aspects for data identification, language deficit, spontaneous recovery and speech therapy. Results: The average age was 62.2 years old (SD= ±12.3), the average time of academic experience was 4.5 years (SD=±3.9), 245 (47.7%) patients presented language disturbance, 166 (54.0%) presented spontaneous recovery, from which 145 (47.2%) had expression deficit (p=0.001); 12 (3.9%) had comprehension deficit and 9 (2.9%) had both expression and comprehension deficit. Speech therapy was carried with 15 patients (4.8%) (p=0.001). Conclusion: The verbal language spontaneous recovery occurred in most of the patients being taken care of at the stroke out clinic, and expression disturbance was the most identified alteration. As expected, the left hemisphere was associated with the deficit and smoking and pregressive stroke were the language alteration primary associated factors.KEY WORDS: aphasia, language, stroke, neuronal plasticity. Recuperação espontânea da linguagem verbal após acidente cerebrovascular isquêmicoResumo -Objetivo: Analisar a recuperação espontânea da linguagem verbal em pacientes que sofreram acidente cerebrovascular isquêmico (AVCI). Método: Análise retrospectiva de 513 prontuários. Caracterizamos aspectos referentes aos dados de identificação, déficit de linguagem, recuperação espontânea, realização de tratamento fonoaudiológico. Resultados: A média de idade foi 62,2 anos (DP=±12,3), o nível de escolaridade teve média de 4,5 anos (DP=±3,9), 245 (47,7%) pacientes apresentaram alteração de linguagem, 166 (54,0%) apresentaram recuperação espontânea sendo 145 (47,2%) do déficit de expressão (p=0,001), 12 (3,9%) de compreensão e 9 (2,9%) misto. A realização de tratamento fonoaudiológico foi encontrada em 15 (4,8%) (p=0,001). Conclusão: A recuperação espontânea da linguagem verbal ocorreu na maioria dos pacientes atendidos no ambulatório de AVCI e a alteração mais encontrada foi de expressão. Como esperado o hemisfério esquerdo associou-se ao déficit, sendo o tabagismo e AVC pregresso fatores preditores de alteração de linguagem. Cerebrovascular disease is responsible for one third of adult's deaths in Brazil, about 125,000 Brazilians suffer a new stroke or present a new recurrent condition every year. It occurs more frequently on individuals above 85 years of age and the occurrence on people below 45 years of age comprises around 10% to 20% of the cases [1][2][3][4] . Among the most frequent stroke aftermath, there is the aphasia, characterized by language disturbance that causes a loss of expression and/or oral and written comprehension, varying from type, level and lesion extension. It occurs in 20% to 30% of the stroke cases and it brings the patient and his caregiver great suffering, resulting from the alterations that affect the communication and life style 5,6 . The aphasias are sorted in expressive, ...

Caracterização de acidente vascular cerebral com enfoque em distúrbios da comunicação oral em pacientes de um hospital regional

“…The objective of this study was to characterize stroke patients by observing the prevalence of communication disorders and subsequent speech therapy rehabilitation follow-up, which failed to reveal significant differences of stroke between sexes; it also confirms the findings in recent studies (16,17) , especially those with detailed description of the studied population and that originated from services with similar characteristics (16,17) , even though other studies have shown a predominance of male (18) or female (19) patients. The stroke most commonly affects adult population, especially from their sixth decade of life onwards, which was proven by some studies (17) and contradicted by others (20,21) .…”

“…Hypertension, on the other hand, is representatively correlated to stroke in different age groups (22) . High blood pressure was the most commonly found chronic disease occurring alone in the research patients (Table 2), which proves the importance of actions aimed at preventing that specific risk factor, since it is associated to several comorbidities (17) . However, in studies with multivariate analysis models, diabetes mellitus was mostly associated to aphasia in the surviving patients (23) , possibly because the disease course is longer than those in cardiovascular diseases.…”

“…The stroke most commonly affects adult population, especially from their sixth decade of life onwards, which was proven by some studies (17) and contradicted by others (20,21) . This research stands out due to the percentage of patients under their 50's who had stroke ( Table 3).…”

“…No significant association was found between the lesion site and the presence of communication disorders. However, studies on this subject have demonstrated that the communication changes in the dominant hemisphere are comprised of difficulties in articulation, oral praxis and language (17,25) . In the non-dominant hemisphere lesions, the articulation and discursive, pragmatic-inferential and lexicosemantics and prosodic abilities are mostly affected (28) .…”

Characterization of self-reported communication disorders in elderly women living in Manaus, state of Amazonas, Brazil

“…Findings related to speech deficit on elderly patients with neurological sequelae deficit showed 47.7% of prevalence. 9,14 The deficits described in the literature refer to changes in speech fluency, hesitations, interjections and corrections which increase with advanced age. [15][16][17][18] Although contradictory, the observed changes in elderly's speech, such as reduced use of complex grammatical structures, verbiage, ambiguous use of benchmarks, the central topic digression, repetition of ideas, overinterruptions, hardship lexical access, overlapping voices, shift work changes, hesitations and repetitions can compromise the cohesion and coherence of the speech, justifying the decline of communication aspects perceived by elderly.…”