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  • Print publication year: 2007
  • Online publication date: October 2009

5 - Acute vascular aphasia

Summary

Introduction

Aphasia has been studied extensively at the acute and subacute stages of stroke (see Chapter 4). However, these important studies do not adequately cover the initial stage (i.e. the first hours and days post-stroke), a critical period for the diagnosis and treatment of stroke. With the development of hyperacute management of stroke, a few studies have re-examined the characteristics, determinants, and prognosis of acute aphasia.

Aphasia at the acute stage of stroke

Aphasia is observed with a prevalence ranging from 21% to 33% of patients admitted for acute stroke (Brust et al., 1976; Laska et al., 2001; Godefroy et al., 2002). A very high prevalence (from 38% to 45%) has been observed at the hyperacute stage with tests including non-aphasic disturbances such as the language subtest of stroke scale (Pedersen et al., 1995) or a naming subtest (Riepe et al., 2004) and this presumably inflates the prevalence of aphasia (Thommessen et al., 2002).

Aphasic syndromes evolve rapidly during the first days post-stroke. Global aphasia is the most frequent syndrome observed with a frequency of about 25% (Laska et al., 2001; Godefroy et al., 2002); Wernicke's aphasia is also frequent (15–25%) followed by anomic aphasia, usually associated with various degrees of minor disorders of oral expression, transcortical motor aphasia, frequently associated with hypophonia in subcortical lesions (Kreisler et al., 2000), and Broca's aphasia (Brust et al., 1976; Laska et al., 2001; Godefroy et al., 2002).

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REFERENCES
Abe, K., Ukita, H., Yorifuji, S. and Yanagihara, T. (1997). Crossed cerebellar diaschisis in chronic Broca's aphasia. Neuroradiology, 39, 624–6.
Aftonomos, L. B., Appelbaum, J. S. and Steele, R. D. (1999). Improving outcomes for persons with aphasia in advanced community-based treatment programs. Stroke, 30, 1370–9.
Alexander, M. P., Naeser, M. A. and Palumbo, C. L. (1987). Correlations of subcortical CT lesion sites and aphasia profiles. Brain, 110, 961–91.
Basso, A., Lecours, A. R., Moraschini, S. and Vanier, M. (1985). Anatomoclinical correlations of the aphasias as defined through computerized tomography: exceptions. Brain Lang., 26, 201–29.
Berthier, M. L. (2005). Poststroke aphasia: epidemiology, pathophysiology and treatment. Drugs Aging, 22, 163–82.
Bhogal, S. K., Teasell, R. and Speechley, M. (2003). Intensity of aphasia therapy, impact on recovery. Stroke, 34, 987–93.
Brust, J. C., Shafer, S. Q., Richter, R. W. and Bruun, B. (1976). Aphasia in acute stroke. Stroke, 7, 167–74.
Cereda, C., Ghika, J., Maeder, P. and Bogousslavsky, J. (2002). Strokes restricted to the insular cortex. Neurology, 59, 1950–5.
Coppens, P. (1991). Why are Wernicke's aphasia patients older than Broca's? A critical view of the hypotheses. Aphasiology, 5, 279–90.
Croquelois, A., Wintermark, M., Reichhart, M., Meuli, R. and Bogousslavsky, J. (2003). Aphasia in hyperacute stroke: language follows brain penumbra dynamics. Ann. Neurol., 54, 321–9.
Doesborgh, S. J., Sandt-Koenderman, W. M., Dippel, D. W., et al. (2003). Linguistic deficits in the acute phase of stroke. J. Neurol., 250, 977–82.
Ferro, J. M. and Madureira, S. (1997). Aphasia type, age and cerebral infarct localization. J. Neurol., 244, 505–9.
Godefroy, O., Rousseaux, M., Pruvo, J. P., Cabaret, M. and Leys, D. (1994). Neuropsychological changes related to unilateral lenticulostriate infarcts. J. Neurol. Neurosurg. Psychiatry, 57, 480–5.
Godefroy, O., Dubois, C., Debachy, B., Leclerc, M. and Kreisler, A. (2002). Vascular aphasias: main characteristics of patients hospitalized in acute stroke units. Stroke, 33, 702–5.
Goodglass, H. and Kaplan, E. (1983). The Assessment of Aphasia and Related Disorders. Philadelphia: Lea and Febiger.
Greener, J., Enderby, P. and Whurr, R. (2000). Speech and Language Therapy for Aphasia Following Stroke. Cochrane Database Syst Rev CD000425.
Greener, J., Enderby, P. and Whurr, R. (2001) Pharmacological Treatment for Aphasia Following Stroke. Cochrane Database Syst Rev CD000424.
Heiss, W. D., Kessler, J., Thiel, A., Ghaemi, M. and Karbe, H. (1999). Differential capacity of left and right hemispheric areas for compensation of poststroke aphasia. Ann. Neurol., 45, 430–8.
Hillis, A. E., Kane, A., Tuffiash, E., et al. (2001). Reperfusion of specific brain regions by raising blood pressure restores selective language functions in subacute stroke. Brain Lang., 79, 495–510.
Hillis, A. E., Wityk, R. J., Barker, P. B., et al. (2002). Subcortical aphasia and neglect in acute stroke: the role of cortical hypoperfusion. Brain, 125, 1094–104.
Hillis, A. E., Barker, P. B., Wityk, R. J., et al. (2004). Variability in subcortical aphasia is due to variable sites of cortical hypoperfusion. Brain Lang., 89, 524–30.
Kennedy, P. G. (1988). A retrospective analysis of forty-six cases of herpes simplex encephalitis seen in Glasgow between 1962 and 1985. Q. J. Med., 68, 533–40.
Kertesz, A. and Sheppard, A. (1981). The epidemiology of aphasic and cognitive impairment in stroke: age, sex, aphasia type and laterality differences. Brain, 104, 117–28.
Kleiser, R., Wittsack, H. J., Butefisch, C. M., Jorgens, S. and Seitz, R. J. (2005). Functional activation within the PI-DWI mismatch region in recovery from ischemic stroke: preliminary observations. Neuroimage, 24, 515–23.
Kreisler, A., Godefroy, O., Delmaire, C., et al. (2000). The anatomy of aphasia revisited. Neurology, 54, 1117–23.
Lacour, A., Seze, J., Revenco, E., et al. (2004). Acute aphasia in multiple sclerosis: A multicenter study of 22 patients. Neurology, 62, 974–7.
Laska, A. C., Hellblom, A., Murray, V., Kahan, T. and Arbin, M. (2001). Aphasia in acute stroke and relation to outcome. J. Intern. Med., 249, 413–22.
Marien, P., Saerens, J., Nanhoe, R., et al. (1996). Cerebellar induced aphasia: case report of cerebellar induced prefrontal aphasic language phenomena supported by SPECT findings. J. Neurol. Sci., 144, 34–43.
Maulaz, A. B., Bezerra, D. C. and Bogousslavsky, J. (2005). Posterior cerebral artery infarction from middle cerebral artery infarction. Arch. Neurol., 62, 938–41.
Nadeau, S. E. and Crosson, B. (1997). Subcortical aphasia. Brain Lang., 58, 355–402.
Nespoulous, J. L., Lecours, A. R. and Lafond, D. (1986). Protocole Montréal-Toulouse de l'examen de l'aphasie, Module Standard Initial (Version Beta). Montréal, Canada: L'Ortho Édition.
Pedersen, P. M., Jorgensen, H. S., Nakayama, H., Raaschou, H. O. and Olsen, T. S. (1995). Aphasia in acute stroke: incidence, determinants, and recovery. Ann. Neurol., 38, 659–66.
Pedersen, P. M., Vinter, K. and Olsen, T. S. (2004). Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovasc. Dis., 17, 35–43.
Pohjasvaara, T., Erkinjuntti, T., Ylikoski, R., et al. (1998). Clinical determinants of poststroke dementia. Stroke, 29, 75–81.
Puel, M., Demonet, J. F., Cardebat, D., et al. (1984). Aphasie souscorticale. Etude neurolinguistique et scangraphique de 25 cas. Rev. Neurol. (Paris), 140, 695–710.
Riepe, M. W., Riss, S., Bittner, D. and Huber, R. (2004). Screening for cognitive impairment in patients with acute stroke. Dement. Geriatr. Cogn. Disord., 17, 49–53.
Tatemichi, T. K., Desmond, D. W., Stern, Y., et al. (1994). Cognitive impairment after stroke: frequency, patterns, and relationship to functional abilities. J. Neurol. Neurosurg. Psychiatry, 57, 202–7.
Thommessen, B., Thoresen, G. E., Bautz-Holter, E. and Laake, K. (2002). Validity of the aphasia item from the Scandinavian Stroke Scale. Cerebrovasc. Dis., 13, 184–6.
Verstichel, P. (2003). Thalamic aphasia. Rev. Neurol. (Paris), 159, 947–57.
Willmes, K. and Poeck, K. (1993). To what extent can aphasic syndromes be localized?Brain, 116, 1527–40.