Speech Recovery Following Global Aphasia Without Hemiparesis

Twelve patients with global aphasia without hemiparesis were studied to determine site of infarction and relate this to severity of aphasia and recovery from It. All patients were studied with CT scans without contrast and the site of the lesion or lesions deter mined by tracing the lesion from standard horizontal slices taken 10 mm apart. Language impairment was determined by the Boston Diagnostic Aphasia Examination and the Aphasia Language Performance Scales, done within four to eight days after onset and at three months following the stroke. All patients had deficits in all language modalities with reduced verbal output, impaired comprehension, impaired reading, writing, and repetition. The CT scans showed that four patients had lesions in language areas located anteriorly, four had lesions posteriorly, and in four the lesions were both anterior and posterior. Recovery was correlated with lesion location and aphasia severity. Those with initially severe aphasia had less good recovery than those with mild language impairment. Correlation of severity, with lesion site showed that those with both anterior and posterior lesions had the most severe impairment and those with either anterior or posterior lesions had the least impairment. Recovery was best in those patients with single lesions. Using the CT scan to determine lesion site;and the initial severity of language deficits can predict outcome accurately in patients with global aphasia without hemiparesis.