Striatal Aphasia : Clinical-CTscan Correlation and Prognosis

Abstract

Fourteen patients with subcortical aphasia secondary to vascular lesions predominantly in the basal ganglia were demonstrated on computed tomographic (CT) scans and studied. The results obtained were as follows : 1) clinical features ; At the onset, the speech disorders rainged from muteness, Broca's aphasia, transcortical motor aphasia with severe dysarthria and diminished motivation to a mild Wernicke aphasia. In the course of recovery, however, relativeiy homogeneous aphasic symptoms were observed. In spite of the nonfluent speech output of some patients, the predominant aphasia pattern for these fourteen cases was that of good grammatical structures and long phrase lengths with prominent paraphasias. Auditory comprehention was relatively good. Nonparaphasic repetition and reading comprehention were the best preserved functions. Confrontation naming and writing were variably impaired. 2) CT lesions ; The difference in lesion volume between cases was relatively large. All of these lesions were deep but some were not subcortical, because they involved the insular cortex. In many cases, they were truly subcortical and confined to the left basal ganglia and neighboring white matter. The common lesion in all patients was in the putamen. 3) prognosis ; The average recovery rate based on serial testing with the Standard Language Test of Aphasia (initial and 3 months later) was significantly higher than any other aphasic group. On the basis of these findings, we suggested that the separate aphasic syndrome of these cases could be defined as “striatal” aphasia or “putaminal” aphasia.