Dynamic Follow Up of Aphasic Disorders in Patients With Ischemic Stroke in Acute Stage

Abstract

SUMMARY:The dynamic follow up of aphasic disorders in patients with acute ischemic stroke is of great importance because of its prognostic value for their future recovery.The purpose of that clinical study is to compare the type of aphasia with the CT data about the infarction localization and to evaluate the prospective aphasia recovery.In the clinical study were included 37 patients with ischemic stroke and aphasia, theated in II-nd Neurology Clinic, Medical University Pleven. The diagnosis ischemic stroke was confirmed by clinical and CT investigations. Partial and full recovery of sensory aphasia was registered in all the patients with total aphasia, while motor aphasia showed little tendency of reduction in acute ischemic stroke. Aphasic disorders were more severe in cases with ischemic infarctions localized in the specific anatomical regions responsible for the speech function. The dynamic follow up of aphasic disorders has prognostic value for the speech recovery. Better prognosis show sensory and amnestic aphasia. Lesion localization also influences the prognosis. Key words: ischemic infarction, aphasia, prognosisThe dynamic follow up of aphasic disorders in patients with acute ischemic stroke is very important because of its prognostic value for their future recovery.The purpose of that clinical study is to compare the type of aphasia and its severity in the acute stage of ischemic stroke with the CT data about the infarction localization and to evaluate the prospective aphasia recovery. MATERIAL AND METHODS37 patients with ischemic stroke and aphasia were included in the clinical study (23 males and 14 females) from 52 to 88 years old, treated in II-nd Neurologic Clinic, University Hospital Pleven for the period from September 2003 till June 2004.The patients were admitted on the 1st -3rd day of the onset and were treated till the 14-th -18-th day. The diagnosis ischemic stroke was confirmed by clinical and CT examination. Neuropsychological tests for expressive, receptive and written speech were performed to assess aphasia type and severity. The patients were tested at the beginning and at the end of the treatment. DYNAMIC FOLLOW UP OF APHASIC DISORDERS IN PATIENTS WITH ISCHEMIC STROKE IN ACUTE STAGE RESULTSPatients distribution according to the type of aphasic disoreders is as follows: 14 (37,9%) with motor aphasia; 12 (32,4%) with amnestic aphasia and 11 (29,7%) with total aphasia (Fig.1).The type and dynamic changes of aphasia according to the CT data are shown on Table 1.In 17 cases a full correspondance between the type of aphasia and the localisation of the infarction lesion is found, while in 20 cases the CT data show ischemic lesion nearby or far away from the specific speech cortical areas.The early CT examination in 8 of the cases done during the 1-st day of the onset is one of the possible reasons a normal CT image to be found. In the group of patients with motor aphasia the reduction of speech disorders reaches higher grades (83,3%) , but a correlation between the localisation and the type...

Clinicoanatomical correlation in stroke related aphasia

“…While some previous studies favor[ 10 13 14 15 ] the concept of a definite correlation between the aphasia type and lesion location in patients with stroke, other studies negate it;[ 11 16 17 18 ] and the debate continues. Majority (65%) of our patients failed to show any conformity between the lesion site and the type of aphasia as per the traditional localizationist aphasia model.…”