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

A 77 year old right handed male was blind since the age of 2. He presented with an infarction involving the territory of the left middle cerebral artery involving the temporal and the inferior parietal lobes. He had learned to read and write language as well as read and write music in braille, ultimately becoming a famous organist and composer. There were no motor or sensory deficits. Wernicke's aphasia with jargonaphasia, major difficulty in repetition, anomia and a significant comprehension deficit without word deafness was present; verbal alexia and agraphia in braille were also present. There was no evidence of amusia. He could execute in an exemplary fashion pieces of music for the organ in his repertory as well as improvise. All his musical capabilities: transposition, modulation, harmony, rythm, were preserved. The musical notation in braille remained intact: he could read by touch and play unfamiliar scores, he could also read and sing the musical notes, he could copy and write a score. Nine months after the stroke his aphasia remained unchanged. Nevertheless he composed pieces for the organ which were published. Such data highly suggest the independence of linguistic and musical competences, defined as the analysis and organization of sounds according to the rules of music. This independence in an extremely talented musician leads to a discussion of the role of the right hemisphere in the anatomical-functional processes at the origin of musical competence. The use of braille in which the same constellations of dots correspond either to letters of the alphabet or musical notes supports the independence between language and music.
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PMID:[Aphasia without amusia in a blind organist. Verbal alexia-agraphia without musical alexia-agraphia in braille]. 361 63

Under observation there was a female patient (a right-hander) who had three ischemic cerebral strokes within a year. After the first stroke she developed an amnestic-sensory aphasia, after the second an auditory and speech agnosia with a complete loss of the ability to understand the speech addressed to her, and after the third stroke she died. Macro- and microscopic examinations showed that the first stroke caused a destruction in the region of the left temporal lobe cortex involving a part of the Heschl convolution; the second stroke resulted in destruction of the right temporal lobe involving almost the whole Heschl convolution. Thus, it has been confirmed that the syndrome can develop only in case of a grave bitemporal damage. Comparative examinations of the speech and audition after the first and the second stroke have shown that in auditory and speech agnosia, the auditory discernment of phonemes, their combinations and the speech prosodic elements is pronouncedly deranged, the formation of conditioned reflexes to sounds of a supraliminal force is disturbed, the detection of short acoustic messages and acoustic filtration are hampered (mainly on the side contralateral to the affected one) the amusia gets more marked and the discernment of rhythms more difficult. All these disturbances are highly dynamic. A question on the role of defects of the right and the left hemispheres in the clinical picture of the auditory and speech agnosia is discussed.
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PMID:[Clinico-experimental study of auditory-speech agnosia (case with anatomo-histologic verification)]. 722

A case of a severe receptive and expressive amusia in a professional musician following a left hemisphere vascular stroke is reported. Recognition and production of single tones and random tone sequences were found to be surprisingly well preserved. In contrast, the recognition and production of simple rhythm patterns were grossly disturbed. It is suggested that amusia is due to the demonstrated rhythm disturbance. Moreover, it has been found that the defect in recognition and reproduction of rhythms was manifested regardless of the modality of perception, i.e. whether rhythm patterns were perceived by audition, vision, or touch. Therefore, the disturbance of rhythm abilities is supramodal in nature, based probably on the perception of time microintervals. Thus, this type of amusia is a result of a non-auditory supramodal defect, i.e., an impairment of temporal pattern recognition.
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PMID:Amusia due to rhythm agnosia in a musician with left hemisphere damage: a non-auditory supramodal defect. 747 74

Aphasia coupled with amusia is reported in a 73-year-old male musician who was a lawyer by profession. This condition followed an ischemic stroke in the lateral aspect of the parieto-occipital region of the left hemisphere. The patient's music production exhibits jargon amusia, similar to that in his verbal production. This case supports the thesis that language and music may share a common hemisphere.
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PMID:Common hemisphericity of language and music in a musician. A case report. 834

Twelve patients with an acute cerebrovascular accident were assigned to a group with music perception deficits (amusia, n = 6) or a group without such deficits (n = 6) on the basis of a new test-battery for music-perception skills. Event-related brain potentials (ERPs) were recorded in an auditory classification task designed to elicit several components; the N1 as a correlate of initial auditory cortical processing, the P3a as an index of automatic attentional orienting, and the P3b as a measure for controlled stimulus evaluation. Patients with amusia showed a significant amplitude decrement for the P3a relative to controls and patients without amusia suggesting an impairment of early stimulus evaluation. P3b was reduced in both patient groups relative to control. These data show that amusia is quite common in unselected stroke patients and suggest deficits of generic rather than music-specific cognitive processes as the underlying cause.
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PMID:Brain potentials in patients with music perception deficits: evidence for an early locus. 985 9

Music perception deficits following acute neurological damage are thought to be rare. By a newly devised test battery of music-perception skills, however, we were able to identify among a group of 12 patients with acute hemispheric stroke six patients with music perception deficits (amusia) while six others had no such deficits. In addition we recorded event-related brain potentials (ERPs) in a passive listening task with frequent standard and infrequent pitch deviants designed to elicit the mismatch negativity (MMN). The MMN in the patients with amusia was grossly reduced, while the non-amusic patients and control subjects had MMNs of equal size. These data show that amusia is quite common in unselected stroke patients. The MMN reduction suggests that amusia is related to unspecific automatic stimulus classification deficits in these patients.
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PMID:Deficit in automatic sound-change detection may underlie some music perception deficits after acute hemispheric stroke. 1152 48

In the auditory modality, there has been a considerable debate about some aspects of cortical disorders, especially about auditory forms of agnosia. Agnosia refers to an impaired comprehension of sensory information in the absence of deficits in primary sensory processes. In the non-verbal domain, sound agnosia and amusia have been reported but are frequently accompanied by language deficits whereas pure deficits are rare. Absolute pitch and musicians' musical abilities have been associated with left hemispheric functions. We report the case of a right handed sound engineer with the absolute pitch who developed sound agnosia and amusia in the absence of verbal deficits after a right perisylvian stroke. His disabilities were assessed with the Seashore Test of Musical Functions, the tests of Wertheim and Botez (Wertheim and Botez, Brain 84, 1961, 19-30) and by event-related potentials (ERP) recorded in a modified 'oddball paradigm'. Auditory ERP revealed a dissociation between the amplitudes of the P3a and P3b subcomponents with the P3b being reduced in amplitude while the P3a was undisturbed. This is interpreted as reflecting disturbances in target detection processes as indexed by the P3b. The findings that contradict some aspects of current knowledge about left/right hemispheric specialization in musical processing are discussed and related to the literature concerning cortical auditory disorders.
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PMID:Cortical auditory disorders: a case of non-verbal disturbances assessed with event-related brain potentials. 1156 3

This study examined the musical processing in a professional musician who suffered from amusia after a left temporo-parietal stroke. The patient showed preserved metric judgement and normal performance in all aspects of melodic processing. By contrast, he lost the ability to discriminate or reproduce rhythms. Arrhythmia was only observed in the auditory modality: discrimination of auditorily presented rhythms was severely impaired, whereas performance was normal in the visual modality. Moreover, a length effect was observed in discrimination of rhythm, while this was not the case for melody discrimination. The arrhythmia could not be explained by low-level auditory processing impairments such as interval and length discrimination and the impairment was limited to auditory input, since the patient produced correct rhythmic patterns from a musical score. Since rhythm processing was selectively disturbed in the auditory modality, the arrhythmia cannot be attributed to a impairment of supra-modal temporal processing. Rather, our findings suggest modality-specific encoding of musical temporal information. Besides, it is proposed that the processing of auditory rhythmic sequences involves a specific left hemispheric temporal buffer.
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PMID:Receptive amusia: temporal auditory processing deficit in a professional musician following a left temporo-parietal lesion. 1499 2

We describe the psychophysical features of vocal amusia in a professional tango singer caused by an infarction mainly involving the superior temporal cortex of the right hemisphere. The lesion also extended to the supramarginal gyrus, the posterior aspect of the postcentral gyrus and the posterior insula. She presented with impairment of musical perception that was especially pronounced in discriminating timbre and loudness but also in discriminating pitch, and a severely impaired ability to reproduce the pitch just presented. In contrast, language and motor disturbances were almost entirely absent. By comparing her pre- and post-stroke singing, we were able to show that her singing after the stroke lacked the fine control of the subtle stress and pitch changes that characterized her pre-stroke singing. Such impairment could not be explained by the impairment of pitch perception. The findings suggest that damage to the right temporoparietal cortex is enough to produce both perceptive and expressive deficits in music.
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PMID:Vocal amusia in a professional tango singer due to a right superior temporal cortex infarction. 1598 78

Intravenous tissue plasminogen activator has become a mainstream treatment for ischemic hyperacute stroke in the adult population. Its safety and efficacy remain undetermined in the pediatric population. We present a teenager who was hospitalized with left-sided paralysis, and with decreased sensations on the left side. Head computed tomography indicated hyperdensity in the middle cerebral artery region, which confirmed the diagnosis of acute ischemic stroke. Her score on the National Institutes of Health stroke scale was 11. She received intravenous tissue plasminogen activator without any complications. At a follow-up visit 5 months after the stroke, the patient manifested mild apraxia in her left hand and mild expressive amusia. This case underscores the need for emergency head imaging in the pediatric population to establish a diagnosis. The excellent recovery in our patient indicates the need to establish thrombolytic treatment as an option for acute stroke in pediatric populations. It also suggests that tissue plasminogen activator can be used safely and effectively, even in pediatric populations. However, further studies are needed to establish the adequate dosage and adverse-effect profile in pediatric populations.
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PMID:Ischemic stroke and excellent recovery after administration of intravenous tissue plasminogen activator. 1820 94


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