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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A group of 53 patients rendered acutely aphasic by occlusive cerebrovascular disease were studied by serial EEG's, repeated neurologic examinations and speech evaluations (Porch Index of Communicative Ability) over a period of eight to twenty-four months, in order to correlate EEG findings with the degree of language disorder and prognosis for language recovery. Normal and mildly abnormal EEG's, posterior slow foci, focal slowing of semirhythmic type and higher alpha frequencies over the intact hemisphere correlated with good language recovery. In the majority of the patients, the curves of "EEG Improvement" and "Language Recovery" closely paralleled each other. These data indicate that the EEG is of prognostic value as to recovery from aphasia in patients suffering from acute occlusive cerebrovascular disease. Despite the advent of newer diagnostic tests, such as CAT scan, which has established its value in evaluation of the anatomy of aphasia, (9) EEG remains to be useful as a tool that could predict the outcome of aphasia in stroke patients.
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PMID:Prognostic value of EEG in acute vascular aphasia: a long term clinical-EEG study of 53 patients. 49 48

A patient is reported who was treated successfully for a left thalamic abscess that resulted in subcortical aphasia. A SPECT scan showed large areas of hypoperfusion in the cortex of the left hemisphere. At follow up after seven months there was marked improvement in the language disorder and the cortical hypoperfusion. It is suggested that aphasia in patients with subcortical lesions results from secondary cortical dysfunctions. The evidence is confined to patients with stroke lesions. The possible implications of this case on current theories of pathophysiological mechanisms, in particular the ischaemic penumbra theory and the cortical diaschisis theory, are briefly discussed. Cortical diaschisis may be the appropriate explanation in this patient.
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PMID:Subcortical aphasia from a thalamic abscess. 158 20

Dissociations between impairments in microlinguistic and macrolinguistic abilities were examined in brain-damaged patients to assess whether these abilities are psychologically and neurologically distinct. The discourse productions of three groups of patients with equally severe fluent language disorders, but varying neuropathology and varying profiles of associated nonlinguistic cognitive impairments, were analyzed. Patients with fluent aphasia secondary to a single left-hemisphere CVA showed the greatest impairment on syntactic and lexical error measures taken to reflect microlinguistic abilities, but normal performance on measures of macrolinguistic organization (i.e., thematic coherence). Patients with probable Alzheimer's Disease were impaired on thematic coherence measures, but not on measures reflecting microlinguistic syntactic and phonological processes. Closed head injury patients whose primary clinical symptom was a fluent language disorder were impaired on both microlinguistic and macrolinguistic measures, which appears to parallel their deficits both in language-specific and in nonspecific, higher-order, diffusely organized cognitive processes.
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PMID:Patterns of discourse production among neurological patients with fluent language disorders. 200 48

A 55-year-old right-handed man showed inability to recognize the meaning of non-verbal sounds without impairment of language comprehension after a cerebrovascular accident. His auditory acuity was intact and no other sign of agnosia, apraxia or aphasia was detectable. His errors on a test of sound recognition were acoustic rather than semantic. Brain CT scan showed a small lesion in the posterior part of the right temporal lobe. This case suggests that auditory sound agnosia without language disorder can ensure a lesion confined to the right hemisphere, and that the deficit is discriminative rather than associative in nature.
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PMID:Auditory sound agnosia without aphasia following a right temporal lobe lesion. 208 56

The hypothesis that the language disorder in Alzheimer's disease (AD) depends on degenerative brain changes in classical left-hemisphere language zones was tested by comparing the written language performances of a group of AD patients with mild-moderate dementia and left-hemisphere stroke patients with equally severe naming and auditory comprehension deficits who were in varying stages of recovery from Wernicke's aphasia. The results indicated significant qualitative group differences in performances between tasks and in errors within tasks. The findings are consistent with hypothesized disruption of more diffusely organized neurolinguistic systems in AD. The hypothesis that the language disorder in AD represents an exaggeration of the pattern of language change in normal aging was also examined by comparing the performances of AD patients to the changes that occur with very advanced normal aging. The data indicate convergence between AD and very elderly healthy subjects in some aspects of written language production.
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PMID:Linguistic and nonlinguistic impairments in writing: a comparison of patients with focal and multifocal CNS disorders. 280 19

A significant proportion of older adults has communication impairments. Language disorders involve problems with the use of learned symbol systems, including numbers, pictures, and words. Aphasia is one of the most common types of language disorders experienced by the elderly and is usually caused by a cerebrovascular accident or stroke, but can also be caused by head trauma and tumors. The growing number of dental patients with this language disorder will challenge the dental team to understand and evaluate aphasia and develop effective communication strategies. This paper describes the language impairments commonly experienced by stroke victims, and discusses assessment and communication strategies specifically for the aphasic dental patient.
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PMID:Communicating with the aphasic dental patient. 750 48

A 12-year-old girl developed Kluver-Bucy syndrome (KBS) following heat stroke. She demonstrated the features typical of human KBS, including visual agnosia, hypermetamorphosis, hypersexuality, language disorder with aphasia, hyperorality, placidity, flat affect, and memory dysfunction. Magnetic resonance imaging 11 1/2 months after onset disclosed mild, diffuse atrophy. Fourteen months after onset, she did not consistently respond to language or communicate verbally, and was dependent on others. A comparison is made with previously reported KBS cases in children.
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PMID:Kluver-Bucy syndrome following heat stroke in a 12-year-old girl. 757 55

Acute language disorder is highly suggestive of cerebrovascular disease, but when accompanied by behavioral disturbance, particularly in elderly patients, it may express a different etiology. Six women aged 71 to 84 years presented with a mild behavioral disturbance followed by a language disorder that included fluent dysphasia, paraphasia, dysnomia, perseveration, and impaired understanding of complex orders. They fully recovered within 24 h. MR-imaging, including diffusion-weighted sequences in five of them, showed no acute lesions. EEG showed epileptogenic waveforms in three cases and slow waves in the other three, in a location that included the left temporal region. These findings disappeared in subsequent controls. All of these tests were performed during the acute episode or up to 72 h after onset. No patient has presented a new episode so far. The high sensitivity of new neuroimaging techniques forces the search for non-vascular etiologies in those patients in which no structural lesions that could account for the symptoms can be demonstrated. EEG can be useful in the diagnosis of some of these stroke mimics. Acute language disorders accompanied by disturbed behavior in the elderly may reflect a partial seizure of the temporal lobe.
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PMID:[Acute language disorder in elderly patients: ischemic or epileptic origin?]. 1174 26

Two young adult dizygotic twins with high schooling suffered two strokes at the ages of 26 and 30 years. On the first occasion, Case 2 suffered a stroke only a few months after Case 1; on the second occasion, Case 1 suffered a second stroke a few months after Case 2. In Case 1, lesions were mainly localized to the left cerebellar hemisphere in both stroke episodes. Case 2 suffered lesions localized to the right cerebellar hemisphere in the first stroke episode, and multiple lesions in both cerebellar hemispheres and the vermis, right pons and left thalamus during the second stroke episode. Seven years after the second stroke, despite full recovery of motor functions, the patients still show mild, yet selective, linguistic deficits (syntactic comprehension deficits, mild agrammatism, reading and writing disorders) without speech disturbances. They also present with selective dysfunctions in visuospatial short-term memory. Language disorders are ascribed to a dysfunction of the cerebellum in Case 1, while in Case 2 a dysfunction of the cerebellum and the thalamus is considered as both structures are part of the so-called 'frontal lobe system', which supports language generation. Visuospatial short-term memory disorders are attributed to an impaired ability to appreciate the organizing structure of the visual task and to poor planning strategies, which are in turn ascribed to cerebellar lesions. The role of the cerebellum in cognitive and linguistic functions is discussed.
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PMID:Long-term neuropsychological deficits after cerebellar infarctions in two young adult twins. 1472 25

Conversation partners of individuals with aphasia, including health care professionals, families, and others, play a role that is as important for communication as the language disorder suffered by individuals with aphasia. Two complementary measures designed to capture elements of conversation between adults with aphasia and their speaking conversation partners have been developed. The first measure provides an index of the conversation partner's skill in providing conversational support. The second provides an index of the level of participation in conversation by the person with aphasia. This article describes the development of the measures, including preliminary psychometric data, and discusses applications.
Top Stroke Rehabil 2004
PMID:A set of observational measures for rating support and participation in conversation between adults with aphasia and their conversation partners. 1487 1


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