Recovery of injured Broca's portion of arcuate fasciculus in the dominant hemisphere in a patient with traumatic brain injury

Jang, Sung Ho; Ha, Ji Wan; Kim, Ho; Seo, You Sung

doi:10.1097/md.0000000000009183

Cited by 11 publications

(5 citation statements)

References 23 publications

(27 reference statements)

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“…Several mechanisms have been proposed currently, including the contribution of either the perilesional region in the affected hemisphere or the homologous language regions in the unaffected hemisphere. [ 1 , 2 ] Thus, it is obvious that the bilateral hemispheres of brain are critical for the recovery of aphasia. In addition, a growing number of literature has pointed out that the white matter tracts play a crucial role in understanding the neural mechanisms of language processing, and determining the nature of language deficits and recovery patterns in aphasia.…”

Section: Introductionmentioning

confidence: 99%

Changes in the corpus callosum during the recovery of aphasia

Yang

Liu

et al. 2018

Medicine

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Rationale:The corpus callosum, which is the most important fiber pathway linking the bilateral hemispheres, plays a key role in information access, as well as the functional coordination and reorganization between the bilateral hemispheres. However, whether the corpus callosum will undergo structural changes during the recovery of aphasia is still unclear. In the current study, a Chinese aphasic patient with stroke was reported to develop changes in the corpus callosum after speech therapy.Patient concerns:A 33-year-old right-handed male patient had aphasia only without limb paralysis at 14 months after stroke.Diagnoses:Neuroimaging evaluation confirmed a diagnosis of cerebral infarction in the left frontal lobe, insula and basal ganglia.Interventions:He underwent 5-month speech therapy and received language function evaluation and DTI examination before and after speech therapy.Outcomes:The result ABC showed that the language functions in the patient, including spontaneous speech, auditory comprehension, repetition and naming, were improved after the speech therapy. In addition, results of follow-up DTT suggested that the fiber pathway between the splenium of corpus callosum and the left superior temporal gyrus (Wernicke's area) had been established. At the same time, fiber connections between the genu of corpus callosum and the right inferior frontal gyrus (the mirror region of Broca's area) were increased.Lessons:The fibrous structure between the corpus callosum and cortical language areas may be reconstructed during the recovery of aphasia. In addition, and the corpus callosum may play an important role in the occurrence and recovery of aphasia after stroke.

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Section: Introductionmentioning

confidence: 99%

Changes in the corpus callosum during the recovery of aphasia

Yang

Liu

et al. 2018

Medicine

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“…Our patient was able to resume speech within a matter of days and was producing a halting speech with appropriate vocabulary and syntax by the time of discharge. Few cases have been published on traumatic insult isolated to Broca's area with no prior studies showing a pure motor deficit [17,18].…”

Section: Discussionmentioning

confidence: 99%

Isolated pure motor apraxia in the setting of depressed skull fracture: A case report and review of the literature

N Harper,

Prakash,

Fossett

2023

Int J Case Rep Images

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Introduction: An isolated pure apraxia of speech following head trauma is a rare clinical presentation in the absence of any other neurologic deficit. It is more commonly seen in patients with vascular pathology. Confusion can exist in recognizing an apraxia of speech versus a true Broca’s aphasia. We report such a case in a patient undergoing significant head trauma. The pathology and its management are discussed. Case Report: A 41-year-old male presented to our Emergency Department with a 3 cm laceration to the left side of the head following an assault with an unknown object. The patient suffered a depressed skull fracture with underlying epidural hematoma, bilateral traumatic subarachnoid hemorrhages, and a resultant isolated pure motor apraxia of speech. He was treated effectively with an emergency frontoparietal craniotomy, elevation and repair of his skull fracture, and evacuation of his epidural hematoma. His pure motor apraxia was greatly improved post-operatively and the patient was referred to outpatient speech therapy with continued neurosurgical follow-up. Conclusion: This case represents the unusual presentation of a pure motor apraxia of speech following traumatic assault to the left frontoparietal skull. An excellent therapeutic response was obtained following surgical intervention and speech therapy.

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“…The main advantage of DTT is that the entire neural tract can be evaluated using the DTT parameters (fractional anisotropy [FA], mean diffusivity, and fiber number) and configurational analysis [ 31 , 32 , 33 ]. As a result, serial DTTs for the language-related neural tracts during the improvement phase appear to be appropriate for the elucidation of the mechanisms of aphasia recovery in them [ 8 , 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 34 , 35 , 36 ]. A significant number of DTT-based studies have reported on the recovery mechanisms of aphasia in various brain pathologies including stroke, traumatic brain injury, and brain tumor [ 8 , 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 34 , 35 , 36 ].…”

Section: Introductionmentioning

confidence: 99%

“…As a result, serial DTTs for the language-related neural tracts during the improvement phase appear to be appropriate for the elucidation of the mechanisms of aphasia recovery in them [ 8 , 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 34 , 35 , 36 ]. A significant number of DTT-based studies have reported on the recovery mechanisms of aphasia in various brain pathologies including stroke, traumatic brain injury, and brain tumor [ 8 , 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 34 , 35 , 36 ]. The majority of the above studies have reported on stroke patients with aphasia [ 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Diffusion Tensor Tractography Studies on Recovery Mechanisms of Aphasia in Stroke Patients: A Narrative Mini-Review

2022

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Aphasia is a common and serious clinical feature of stroke. Various neural tracts are known to be involved in language processing. Diffusion tensor tractography (DTT) appears to be an appropriate imaging technique for the elucidation of the recovery mechanisms of aphasia in the language-related neural tracts in stroke patients. In this article, twelve previous DTT-based studies on the recovery mechanisms of aphasia in stroke were reviewed. We classified the twelve studies into the following three categories according to the recovery mechanisms: recovery via the neural tracts in the dominant hemisphere (eight studies), via transcallosal fibers (two studies), and via the neural tracts in the non-dominant hemisphere (two studies). Although there are various neural tracts for language processing, eight of the ten studies focused only on the role of the arcuate fasciculus (AF) in the recovery process. Consequently, it appears from the studies that only one recovery mechanism of aphasia via the restoration of the integrity of the injured AF in the dominant hemisphere was clearly demonstrated. However, because various neural tracts are involved in language processing, there could be other mechanisms that have not yet been elucidated. Therefore, further original studies involving a larger number of patients with aphasia in stroke should be encouraged forthwith. Further studies involving various lesion locations and severity levels of injuries to the language-related neural tracts are also necessary because the recovery mechanisms of aphasia in stroke could be dependent on these factors.

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Recovery of injured Broca's portion of arcuate fasciculus in the dominant hemisphere in a patient with traumatic brain injury

Cited by 11 publications

References 23 publications

Changes in the corpus callosum during the recovery of aphasia

Changes in the corpus callosum during the recovery of aphasia

Isolated pure motor apraxia in the setting of depressed skull fracture: A case report and review of the literature

Diffusion Tensor Tractography Studies on Recovery Mechanisms of Aphasia in Stroke Patients: A Narrative Mini-Review

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