Aphasia in acute stroke and relation to outcome

Laska, Ann‐Charlotte; Hellblom, A.; Murray, Veronica; Kahan, Thomas; Arbin, Magnus von

doi:10.1046/j.1365-2796.2001.00812.x

Cited by 461 publications

(342 citation statements)

References 27 publications

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“…However, thrombolytic treatment did not significantly influence survival on this sample (ρ=0.591). DISCUSSION Short-term mortality was higher for patients with aphasia in this sample, more often so when global aphasia was present, in accordance with other authors 5 . Some studies have revealed that long-term mortality is correlated with the occurrence of aphasia as well 1,5 .…”

Section: Resultssupporting

confidence: 92%

“…DISCUSSION Short-term mortality was higher for patients with aphasia in this sample, more often so when global aphasia was present, in accordance with other authors 5 . Some studies have revealed that long-term mortality is correlated with the occurrence of aphasia as well 1,5 . Global aphasia has also been shown to bring an unfavorable prognosis to post-stroke mobility recovery 16 ; this could be phylogenetically related to the simultaneous development of language networks and motor gesture activity in earlier primates 17 .…”

Section: Resultssupporting

confidence: 92%

“…The severity of vascular aphasic syndromes is usually associated with stroke severity 5 . Controversial results in regard to evaluation of aphasia may be obtained in the presence of confusion factors like the catastrophic reaction 26 and post-stroke depression 27 , which are more frequent in aphasic patients (probably as a reactional mechanism).…”

Section: Resultsmentioning

confidence: 99%

“…Patients with nonfluent aphasias may evolve to fluent forms 5,6 , but when global aphasia is present in the acute stroke phase and does not completely resolve, a predominant loss of fluency is often observed 6 . Interobserver agreement is usually lower among patients assessed very early and very late after symptom onset.…”

Section: Resultsmentioning

confidence: 99%

“…Stroke is the leading cause of aphasia, which increases acute and chronic mortality rates after the cerebrovascular event 5 . Nonetheless, most studies that correlate stroke outcomes with aphasia evaluate recovery, not mortality.…”

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confidence: 99%

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Global aphasia as a predictor of mortality in the acute phase of a first stroke

Oliveira

Damasceno

2011

Arq. Neuro-Psiquiatr.

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Objective: To establish whether vascular aphasic syndromes can predict stroke outcomes. Method: Thirty-seven adults were evaluated for speech and language within 72 hours after a single first-ever ischemic brain lesion, in blind association to CT and/or MR. Results: Speech or language disabilities were found in seven (87.5%) of the eight deceased patients and twenty-six (89.7%) of the twenty-nine survivors. Global aphasia was identified in eleven patients, all with left hemisphere lesions (nine mute; five deceased), consisting on a risk factor for death in the acute stroke phase (ρ=0.022). Age (z=1.65; ρ>0.09), thrombolysis (ρ=0.591), infarct size (ρ=0.076) and side (ρ=0.649) did not significantly influence survival. Absence of aphasia did not predict a better evolution, regardless of the affected hemisphere. Prevalence of cardiovascular risk factors was similar for all patient groups. Conclusion: Global aphasia in acute stroke can adversely affect prognosis, translated into impairment of dominant perisylvian vascular territories, with mutism as an important semiological element. Key words: linguistics, aphasia, stroke, brain infarction, language, speech, disability evaluation, prognosis.Afasia global prediz mortalidade na fase aguda de um primeiro acidente vascular cerebral isquêmico RESUMO Objetivo: Determinar se síndromes afásicas na fase aguda do infarto cerebral influenciam o prognóstico. Método: Avaliação para fala e linguagem de 37 adultos dentro de 72 horas após um primeiro infarto cerebral, em associação topográfica cega com TC e/ou RM. Resultados: Detectaram-se afasias ou disartria em 7 (87,5%) dos 8 pacientes falecidos, e em 26 (89,7%) dos 29 sobreviventes. Afasia global foi identificada em 11 pacientes, todos com lesões no hemisfério esquerdo (cinco óbitos; mutismo em nove), consistindo em fator de risco para mortalidade na fase aguda do acidente vascular cerebral isquêmico (ρ=0,022). Idade (z=1,65; ρ>0,09), trombólise (ρ=0,591), dimensões da lesão (ρ=0,076) e lado (ρ=0,649) não afetaram significativamente a sobrevivência. Ausência de afasia não prenunciou melhor evolução. Fatores de risco cardiovascular tiveram similar prevalência para todos os grupos de pacientes. Conclusão: Afasia global na fase aguda do infarto cerebral pode aumentar mortalidade, demonstrando envolvimento de território vascular perisylviano dominante, tomando-se mutismo como importante elemento semiológico. Palavras-chave: linguística, afasia, acidente cerebral vascular, infarto encefálico, linguagem, fala, avaliação da deficiência, prognóstico.

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Section: Resultssupporting

confidence: 92%