Articles: aphasia-etiology.
-
Aphasia describes language impairment associated with a brain lesion. ⋯ The main conclusion of this review is that speech and language therapy treatment for people with aphasia after a stroke has not been shown either to be clearly effective or clearly ineffective within a RCT. Decisions about the management of patients must therefore be based on other forms of evidence. Further research is required to find out if effectiveness of speech and language therapy for aphasic patients is effective. If researchers choose to do a trial, this must be large enough to have adequate statistical power, and be clearly reported.
-
Foix-Chavany-Marie syndrome (FCMS) is a syndrome that presents facio-pharyngo-glosso-masticatory diplegia with automatic voluntary dissociation. Its most common etiology is stroke in the regions of bilateral opercula. We described a 75-year-old woman with FCMS and crossed aphasia. ⋯ Our patient did not show aphasia after the first stroke including left language area, but became severely aphasic after the right corona radiata infarction. Simultaneous occurrence of FCMS and aphasia after corona radiata lesion suggested that the corticobulbar tract and a tract that conducts linguistic information are running adjacently in the corona radiata. Our case suggested that restricted corona radiata lesion may cause severe subcortical aphasia and in case of additional contralateral corticobulbar tract lesion, severe dysarthria may occur.
-
In normal subjects, regional cerebral blood flow (rCBF) is greatly increased by neuronal activity, whereas the cerebral metabolic rate for O2 is increased only slightly. However, it is not clear what kinds of cerebral blood oxygenation and hemodynamic changes can be induced by language activities in language-relevant areas of poststroke aphasics. In the present study, we investigated the difference in the changes of cerebral blood oxygenation and hemodynamics in the left prefrontal cortex induced by language activities between normal subjects, poststroke nonaphasic patients, and nonfluent aphasic patients using near-infrared spectroscopy (NIRS). ⋯ The present results demonstrate a multiplicity of language-activated cerebral blood oxygenation and hemodynamic changes in the left prefrontal cortex in the nonaphasic and aphasic groups. The increase of deoxy-Hb with increases of oxy-Hb and total-Hb in the aphasics during language tasks suggests that the left prefrontal cortex of the aphasics utilizes more oxygen than the nonaphasics during language tasks. Finally, functional MRI, which images the activation area in the brain by detecting the reduced concentration of deoxy-Hb during neuronal activation, should be performed on the patients with cerebral dysfunction, giving special consideration to the possible multiplicity of the rCBF and cerebral oxygen metabolism responses to functional tasks.