ABSTRACT
Severe Wernicke's aphasia occurred suddenly in a right-handed man and persisted with little improvement until he died 54 days later. Postmortem examination showed an infarct in the posterior temporoparietal region of the right hemisphere. This case demonstrates two new features of crossed dextral aphasia. First, language skills may be fully lateralized to the right hemisphere in right-handed patients. Second, when crossed lateralization occurs, the usual localization of aphasic syndromes is common, suggesting that the intrahemispheric organization mediating language activities is the same in the right hemisphere of the crossed dextral and the left hemisphere of the typical right-handed individual.
Subject(s)
Aphasia, Wernicke/physiopathology , Aphasia/physiopathology , Brain/pathology , Dominance, Cerebral , Functional Laterality , Aged , Aphasia, Wernicke/etiology , Aphasia, Wernicke/pathology , Cerebral Hemorrhage/complications , Cerebral Hemorrhage/pathology , Humans , MaleABSTRACT
The clinical and angiographic features of cervical and ocular bruits were correlated in 50 consecutive patients with severe extracranial internal carotid artery occlusive disease. Cervical bruits, generally localized to the carotid bifurcation, were highly associated (P = 0.004) with "tight" (residual lumen less than or equal to 2 mm) internal carotid artery stenosis, but significantly less often with a widely patent or occluded internal carotid artery. Angiographic features of a "slow-flow" state through a patent, but "tight" stenosis were identified as the apparent explanation for the absence of bruit in some patients. A unilateral ocular bruit contralateral to the side of internal carotid artery occlusion occurred in 9 of 10 patients, more often than an associated cervical bruit, and was interpreted as a sign of augmentation flow.
