Aphasia following striatocapsular infarction may be explained by concomitant small cortical infarct on diffusion-weighted imaging

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Han, Moon-Ku; Kang, Dong-Wha; Jeong, Sang-Wuk; Roh, Jae-Kyu
Issue Date
Cerebrovasc Dis. 2005;19(4):220-4. Epub 2005 Feb 8.
AgedAphasia/etiology/*pathologyCerebral AngiographyCerebral Cortex/pathologyCerebral Infarction/complications/*pathologyCorpus Striatum/pathology*Diffusion Magnetic Resonance ImagingFemaleHumansInternal Capsule/pathologyMaleMiddle AgedTelencephalon/*pathology
BACKGROUND: The underlying mechanism of aphasia following striatocapsular infarction (SCI) remains controversial. We hypothesized that aphasia resulting from SCI might be associated with concomitant cortical lesions, which can be demonstrated by diffusion-weighted imaging (DWI). METHODS: We analyzed 24 patients with left SCI who underwent DWI and MR angiography within 2 days after the onset. Aphasia was assessed by the modified Korean version of the Boston Diagnostic Aphasia Examination test. RESULTS: DWI showed the presence of additional ischemic lesions involving the cortical areas in 13 of 24 SCI patients (54%). Ten patients (42%) showed aphasia. All 10 patients with aphasia had cortical lesions in addition to SCI (p = 0.0002), whereas 21% (3/14) of the nonaphasic patients had additional cortical lesions. Conventional MRI did not reveal the presence of corresponding acute cortical lesions in any of the aphasic patients. There was no difference between the patients with and without aphasia in terms of their stroke etiology. CONCLUSIONS: Our data suggest that aphasia due to SCI in the acute stage may be attributed to direct cortical injury, whose presence can be demonstrated by DWI, even though it might be invisible on conventional imaging.
1015-9770 (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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