Analysis of Aphasia Patients Resulting from Acute Ischemic Stroke Using Quantitative Methods of Aphasia Test

ABSTRACT

BACKGROUND: Aphasia is common in stroke patients. However, studies about characteristics and prog- nosis of aphasia by acute ischemic stroke were insufficient. The aim of this study is to disclose vascular lesions causing aphasia symptom and to evaluate and clarify types, severity and recovery patterns of vascular aphasia using quantitative aphasia test. METHODS: Twenty six patients were included in this study, who had aphasia symptoms due to acute ischemic lesions confirmed by MRI or CT. Standardized test of Korean version-the Western Aphasia Battery (K-WAB) was performed in all subjects in acute stagte of stroke and was repeated 3 month later. Based on neuroimaging findings and results of aphasia tests, we divided all subjects into two groups, cortical aphasia and subcortical aphasia, and classified further into 8 types. The severity of aphasia measured by aphasia quotient (AQ) was graded. Changes in aphasia types and AQ and prognosis between cortical and subcortical aphasia was analyzed. RESULTS: Various vascular lesions caused aphasia symptoms in cortical and subcortical areas with good clinico-anatomical correlations. Eighteen patients(69.2%) had cortical aphasia and 8(30.8%) had subcor- tical one. Among 8 types of aphasia, 7 types were detected in our patients, and the most frequent type is global aphasia(30.8%). The mean incremental score of AQ between initial and follow-up test was 21.1+/-14.0. The distribution of severity of aphasia was as follows; grade I, 3.8%; grade II, 19.2%; grade III, 42.3%; and grade IV, 34.6%. Twenty one patients(80.8%) were followed up 97.9+/-7.4 days after initial test. Subjects who showed improvement in aphasia were 13(61.9%). Nine out of 13 belonged to cortical aphasia group and 4 out of them belonged to subcortical aphasia group. There was no significant difference in prognosis between cortical and subcortical aphasia group(p=0.58). CONCLUSION: Our study discloses various acute vascular lesions cause aphasia. It also provides cha- racteristics of patients with aphasia by acute ischemic stroke, such as types, severities and recovery patterns, which may help to assess vascular aphasia and its prognosis.