1/203. A case of mixed transcortical aphasia with intact naming.Altholgh Lichtheim recognized that Wernicke's 'reflex arch' (primary auditory area, to Wernicke's area, to Broca's area, to primary motor area) was important for repetition, he recognized that other areas of the brain (for example, area of concepts or semantic area) must be important in comprehension and voluntary speech. He suggested that Wernicke's area (phonemic area) not only projected to Broca's area (as Wernicke suggested) but that it also projected to the area of concepts. A lesion of this latter pathway or in the area of concepts would produce a syndrome where repetition was intact but comprehension was impaired (e.g. transcortical sensory aphasia). Lichtheim also thought that the area of concepts projected directly to Broca's area and that voluntary speech was mediated by this pathway. Although Lichtheim's model could explain the mechanism underlying transcortical aphasia, his schema could not explain anomic aphasia. Unlike Lichtheim's schema, Kussmaul's schema suggested that the area of concepts projects back to Wernicke's area before projecting to Broca's area. With this schema, a patient with a hypothetical lesion which interrupted the pathway from the area of concepts to Wernicke's area (but did not interrupt the pathway from Wernicke's area to the area of concepts) should be anomic, with normal comprehension and repetition. In order for this latter schema to be plausible there should also be a lesion which interrupts the pathway from Wernicke's area to the area of concepts but does not interrupt the pathway which goes from the area of concepts to Wernicke's area. A patient with this hypothetical lesion should comprehend poorly; however, in spite of poor comprehension, naming and repetition should be intact. We report a patient who demonstrates poor comprehension with intact naming and repetition. This patient could also read aloud but could not comprehend written language. Not only could this patient name objects but he could demonstrate their use. These observations suggest that comprehension of written language is mediated by a different pathway than the recognition of visually presented objects.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/203. Conduction aphasia elicited by stimulation of the left posterior superior temporal gyrus.OBJECTIVE: Disruption of fascicular tracts that connect Wernicke's to Broca's areas is the classic mechanism of conduction aphasia. Later work has emphasised cortical mechanisms. methods: To determine the distribution of language on dominant cortex, electrical cortical stimulation was performed using implanted subdural electrodes during brain mapping before epilepsy surgery. RESULTS: A transient, isolated deficit in repetition was elicited with stimulation of the posterior portion of the dominant superior temporal gyrus. CONCLUSION: This finding suggests that cortical dysfunction, not just white matter disruption, can induce conduction aphasia.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
3/203. Traumatic aphasia in children: a case study.Traumatic aphasia in children has been recognized as a distinct clinical pathology, differing from adult aphasia in symptomatology and course of recovery. The upper limit for complete recovery has been identified as age 10. However, there is a paucity of literature documenting recovery of children with traumatic aphasia. It is apparent that definitive statements of the upper age limit for complete recovery from traumatic aphasia in children cannot be made at this time. This article reviews the literature concerning traumatic aphasia and presents case information of a 10-year-old traumatic aphasic girl seen at the North texas State University speech and hearing Center. The design, execution, and assessment of therapeutic interaction and the observed language abilities of the client are reported.- - - - - - - - - - ranking = 0.00055785570804734keywords = trauma (Clic here for more details about this article) |
4/203. Global aphasia: an innovative assessment approach.OBJECTIVE: To provide an alternative language comprehension assessment strategy for patients unable to be tested with traditional verbally/behaviorally based methods. DESIGN: Event-related brain potentials were recorded from three midline scalp locations to visually and aurally computer-presented sentences, 50% of which were semantically appropriate and 50% semantically incongruous. SETTING: A rehabilitation hospital. PATIENT: A 21-year-old man with a traumatic brain injury. RESULTS: The patient exhibited brain response patterns to aurally presented congruous and incongruous sentences indicative of intact semantic processing capabilities. These findings resulted in reinstatement of individualized rehabilitative intervention, with a successful outcome. CONCLUSIONS: This innovative technique provides new opportunities for assessing intellectual function in noncommunicative patients who were patients previously unable to be tested.- - - - - - - - - - ranking = 7.1402429170842keywords = brain injury, brain, traumatic brain injury, traumatic brain, injury, trauma (Clic here for more details about this article) |
5/203. subclavian artery stenosis caused by non-specific arteritis (Takayasu disease): treatment with Palmaz stent.A 32-year old woman was admitted to the hospital with a sudden onset of right-sided hemiplegia and aphasia. Immediate angiographic examination revealed a severe form of type I takayasu arteritis with occlusion of all supra-aortic vessels, with the exception of the left subclavian artery which was, however, almost completely occluded 1 cm proximal to the origin of the left vertebral artery. Since the latter provided the entire blood supply to the brain tissues, an immediate attempt was undertaken to dilate the left subclavian artery; when this was unrewarding, stenting of the lesion was successfully accomplished with excellent primary and 6-month follow-up results.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
6/203. The relation of phoneme discrimination, lexical access, and short-term memory: A case study and interactive activation account.A brain-damaged patient (AP) is reported who had a strong tendency to identify nonwords as words on auditory lexical decision and to lexicalize nonwords in repetition, yet who showed a normal ability to perceive individual phonemes. It was initially hypothesized that these findings could be accounted for in terms of disrupted lexical phonological representations. This hypothesis was rejected on the basis of an interactive activation model of word recognition which revealed that modifications at the lexical level did not mimic the patient's pattern of results. Instead, it was found that increasing the rate of decay of activation at the phoneme level produced output that was consistent with the phoneme discrimination, lexical decision, and repetition results. This hypothesis of increased phoneme level decay led to the prediction that speech discrimination would decline with increased interstimulus interval and that short-term memory performance would be impaired. Both predictions were confirmed. The results of this study provide support for an interactive activation model of word recognition with feedback from the lexical to the phonemic level and for a close connection between the processes involved in word recognition and short-term memory.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
7/203. Management of penetrating injury to the petrous internal carotid artery: case report.We report the management of a penetrating foreign body injury to the neck with a length of fencing wire traversing the internal carotid artery within the petrous temporal bone and entering the middle cranial fossa. Discussion points include methods of haemorrhage control, as well as ligation versus repair or bypass as the definitive treatment.- - - - - - - - - - ranking = 0.21705496742513keywords = injury (Clic here for more details about this article) |
8/203. Rapidly progressive aphasia and motor neuron disease: a clinical, radiological, and pathological study of an autopsy case with circumscribed lobar atrophy.This report concerns an autopsy case of rapidly progressive aphasia and motor neuron disease. The patient was a Japanese woman who was 75 years old at the time of death. The family history did not reveal hereditary burden. She developed language disturbances and difficulty in swallowing at age 74. Neurological examination 1 month after the disease onset revealed motor aphasia without dementia and bulbar sign, followed by muscle weakness of the four extremities. Neuroradiological examination revealed progressive atrophy of the anterior part of the left temporal lobe. She died of respiratory difficulty 10 months after the disease onset. Macroscopically, neuropathological examination showed circumscribed atrophy of the left perisylvian region and, histologically, neuronal loss in the cerebral cortex, including the primary motor area, substantia nigra, brain stem motor nuclei, and anterior horns of the spinal cord, in addition to obvious degeneration of the pyramidal tracts and presence of Bunina bodies. ubiquitin-immunoreactive neuronal inclusions were present in the hippocampal dentate granular cells and frontotemporal cortical layer II neurons. Based on these clinicopathological findings and a review of the literature, we concluded that our case is the first reported case of amyotrophic lateral sclerosis with dementia that clinically showed rapidly progressive aphasia.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
9/203. Right hemisphere semantic processing of visual words in an aphasic patient: an fMRI study.This study was designed to identify the neural network supporting the semantic processing of visual words in a patient with large-scale damage to left-hemisphere (LH) language structures. Patient GP, and a control subject, RT, performed semantic and orthographic tasks while brain-activation patterns were recorded using functional magnetic resonance imaging. In RT, the semantic-orthographic comparison activated LH perisylvian and extrasylvian temporal regions comparable to the network of areas activated by non-brain-damaged subjects in other neuroimaging studies of semantic discrimination. In GP, the same comparison activated homologous right-hemisphere regions, demonstrating the ability of the right hemisphere to subserve visual lexicosemantic processes. The results are discussed within the context of the normal right hemisphere's capacity for semantic processing of visual words. Examining results from functional neuroimaging studies on recovery in the context of innate hemispheric abilities may enable reconciliation of disparate claims about mechanisms supporting recovery from aphasia.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
10/203. language and calculation within the parietal lobe: a combined cognitive, anatomical and fMRI study.We report the case of a patient (ATH) who suffered from aphasia, deep dyslexia, and acalculia, following a lesion in her left perisylvian area. She showed a severe impairment in all tasks involving numbers in a verbal format, such as reading aloud, writing to dictation, or responding verbally to questions of numerical knowledge. In contrast, her ability to manipulate non-verbal representations of numbers, i.e., Arabic numerals and quantities, was comparatively well preserved, as evidenced for instance in number comparison or number bisection tasks. This dissociated impairment of verbal and non-verbal numerical abilities entailed a differential impairment of the four arithmetic operations. ATH performed much better with subtraction and addition, that can be solved on the basis of quantity manipulation, than with multiplication and division problems, that are commonly solved by retrieving stored verbal sequences. The brain lesion affected the classical language areas, but spared a subset of the left inferior parietal lobule that was active during calculation tasks, as demonstrated with functional MRI. Finally, the relative preservation of subtraction versus multiplication may be related to the fact that subtraction activated the intact right parietal lobe, while multiplication activated predominantly left-sided areas.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
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