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

Clinical and tomographic examinations of 40 patients with aphasia developed after an ischemic stroke were carried out. In more than half of them no correlation between the aphasia gravity and character on the one hand, and the size and localization of the ischemic focus (or foci) in the brain on the other was noted. With similar character and gravity of the speech disorder the size and localization of the ischemic foci may be different, ad vice versa. It has been shown that the interrelations between the focal pathology of the brain and the character and gravity of speech disorders are very complicated. One should take into consideration the possibility of individual organization of the speech functions, the degree of the speech activity automatism before the disease, and the state of the cerebrovascular system as a whole.
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PMID:[Speech syndrome and its course in patients who have sustained an ischemic stroke (clinico-tomographic study)]. 731 47

About one fourth of the patients affected by apoplexy develop an aphasic speech defect. The greater proportion of recovery occurs within the first three months after the apoplectic insult. The remainder of the recovery usually occurs in the subsequent three months and this, as a rule, is limited. According to the majority of investigations, significant improvement in speech is relatively rare after six months. The severity of the aphasia is closely connected with the degree of severity of the apoplexy. Patients with severe apoplexy and severe aphasia have poorer prognoses than patients with mild apoplexy and mild aphasia. Patients with severe aphasia also recover more slowly than patients with mild aphasia. The tendency to recover is independent of sex. It is uncertain whether age plays a part in recovery. The greater proportion of recovery is spontaneous. It is uncertain whether speech therapy affects recovery at all. The two randomised investigations which have hitherto been published have contradictory results. Four randomised investigations in which speech therapy was compared with supportive non-speech therapy provided by a volunteer (eg an interested relative or friend with training in speech therapy) show unequivocally that recovery is independent of whether treatment is provided by a speech therapist or by volunteer. The therapeutic possibilities which are offered to victims of apoplexy at present are not satisfactory. New approaches and new developments are required in this field.
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PMID:[Aphasia following apoplexy. Frequency, remission and effect of treatment]. 768 May 5

This is an appraisal of the varied clinical presentation and the neural substrate for akinetic mutism following stroke. The diagnosis is important as akinetic mutism is often misdiagnosed as depression, delirium and locked-in-syndrome. This is a descriptive study of eight selected patients with akinetic mutism following infarction/haemorrhage in different regions of the brain with characteristic syndromes. They involved the critical areas namely, the frontal (cingulate gyrus, supplementary motor area and dorso-lateral border zone), basal ganglia (caudate, putamen), the mesencephalon and thalamus. The disorders of speech and communication took different forms. The speech disorder included verbal inertia, hypophonia, perseveration, softened and at times slurred. The linguistic disturbances were fluent, non-fluent, anomia and transcortical (motor, mixed) aphasias. The findings were related to what is known about the neuroanatomic location of the lesions and the role of the frontal-subcortical circuitry in relation to behaviour. Akinetic mutism could be explained by damage to the frontal lobe and or interruption of the complex frontal subcortical circuits.
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PMID:Akinetic mutism following stroke. 1464 61

This article reports on research investigating barriers to achieving patient-centered communication (PCC) with patients who have stroke-related communication disorders. A focus group, including people who had strokes and their family members, identified PCC issues they encounter when communicating with health care providers. The two key themes that emerged from this research were the desire to be treated with respect and the importance of allowing adequate time for a person with a speech disorder to communicate. Suggestions are given for improving PCC with people who have stroke-related communication disorders.
Top Stroke Rehabil 2006
PMID:A preliminary investigation of barriers to achieving patient-centered communication with patients who have stroke-related communication disorders. 1658 32

Foreign accent syndrome (FAS) is a rare speech disorder characterised by the emergence of a new accent, perceived by listeners as foreign. FAS has usually been described following focal brain insults, such as stroke. We describe the unusual case of a woman presenting with FAS as the earliest symptom of progressive degenerative brain disease. At presentation, she showed no language or other cognitive impairment, and functional and structural brain imaging were normal. Follow-up 1 year later revealed the emergence of mild expressive language problems. Repeat functional neuroimaging showed mild hypoperfusion of the perisylvian speech area of the left hemisphere, and structural imaging showed mild left perisylvian atrophy. We interpret the case as an unusual presentation of primary progressive non-fluent aphasia. The case provides further evidence of the variable and circumscribed nature of the clinical presentation of focal cerebral degeneration.
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PMID:Foreign accent syndrome as the initial sign of primary progressive aphasia. 1763 73

Aphasia is a speech disorder usually caused by stroke or head injury and may involve a variety of communication difficulties. As 30% of stroke sufferers have a persisting speech and language disorder and therapy resources are low, there is clear scope for the development of technology to support patients between therapy sessions. This paper reports on an empirical study which evaluated SoundHelper, a multimedia application to demonstrate how to pronounce target speech sounds. Two prototypes, involving either video or animation, were developed and evaluated with 20 Speech and Language Therapists. Participants responded positively to both, with the video being preferred because of the perceived extra information provided. The potential for the use on portable devices, since internet access is limited in hospitals, is explored in the light of opinions of Augmented and Alternative Communication (AAC) device users in the UK nd Europe who have expressed a strong desire for more use of internet services.
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PMID:A multimedia PDA/PC speech and language therapy tool for patients with aphasia. 1804 66

Abstract In The Netherlands, a web application for speech training, E-learning-based speech therapy (EST), has been developed for patients with dysarthria, a speech disorder resulting from acquired neurological impairments such as stroke or Parkinson's disease. In this report, the EST infrastructure and its potentials for both therapists and patients are elucidated. EST provides patients with dysarthria the opportunity to engage in intensive speech training in their own environment, in addition to undergoing the traditional face-to-face therapy. Moreover, patients with chronic dysarthria can use EST to independently maintain the quality of their speech once the face-to-face sessions with their speech therapist have been completed. This telerehabilitation application allows therapists to remotely compose speech training programs tailored to suit each individual patient. Moreover, therapists can remotely monitor and evaluate changes in the patient's speech. In addition to its value as a device for composing, monitoring, and carrying out web-based speech training, the EST system compiles a database of dysarthric speech. This database is vital for further scientific research in this area.
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PMID:E-learning-based speech therapy: a web application for speech training. 2018 55

Communication problems resulting from acquired brain damage are most frequently manifested as motor speech disorders such as dysarthria, syndromes of aphasia, and impairments of pragmatics. A much less common phenomenon is the onset of stuttering in adults who sustain a stroke, traumatic brain injury, or other neurologic events. When stuttering occurs in association with neuropathology, precise characterization and explanation of observed behaviors is often difficult. Among the clinical challenges presented by acquired stuttering are the problem of distinguishing this form of dysfluency from those associated with dysarthria and aphasia, and identifying the neuropathological condition(s) and brain lesion site(s) giving rise to this speech disorder. Another challenge to the precise characterization of acquired stuttering is the fact that some cases of acquired stuttering apparently have a psychological or neuropsychiatric genesis rather than a neuropathological one. In this paper we provide a review of the literature pertaining to the complicated phenomenon of acquired stuttering in adults and draw some tentative explanatory conclusions regarding this disorder.
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PMID:Stuttering Following Acquired Brain Damage: A Review of the Literature. 2062 82

Aphemia is an apraxia of speech characterized by complete articulatory failure in the presence of preserved writing, comprehension and oropharyngeal function and can be the presenting manifestation of acute stroke. The responsible lesion is commonly in the left inferior frontal gyrus or the left motor cortex near the face M1 area. Three patients who developed aphemia due to acute ischemic stroke are described here. All had apraxia of speech due to acute infarct in the left motor cortex near face M1 area. Understanding the underlying speech disorder is crucial in planning the appropriate rehabilitation strategy.
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PMID:Aphemia as a presenting symptom in acute stroke. 2174 77

Neurogenic stuttering is an acquired speech disorder characterized by the occurrence of stuttering-like dysfluencies following brain damage. Because the onset of stuttering in these patients is associated with brain lesions, this condition provides a unique opportunity to study the neural processes underlying speech dysfluencies. Lesion localizations of 20 stroke subjects with neurogenic stuttering and 17 control subjects were compared using voxel-based lesion symptom mapping. The results showed nine left-hemisphere areas associated with the presence of neurogenic stuttering. These areas were largely overlapping with the cortico-basal ganglia-cortical network comprising the inferior frontal cortex, superior temporal cortex, intraparietal cortex, basal ganglia, and their white matter interconnections through the superior longitudinal fasciculus and internal capsule. These results indicated that stroke-induced neurogenic stuttering is not associated with neural dysfunction in one specific brain area but can occur following one or more lesion throughout the cortico-basal ganglia-cortical network. It is suggested that the onset of neurogenic stuttering in stroke subjects results from a disintegration of neural functions necessary for fluent speech.
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PMID:A crucial role for the cortico-striato-cortical loop in the pathogenesis of stroke-related neurogenic stuttering. 2245 28


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