Aphasia Induced by Infratentorial Ischemic Stroke: Two Case Reports
Aphasia Induced by Infratentorial Ischemic Stroke: Two Case Reports
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DOI：
10.1097/wnn.0000000000000266
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发表时间：
2021-06-01
影响因子：
1.4
通讯作者：
Yonehara, Toshiro
中科院分区：
文献类型：
--
作者：
Inatomi, Yuichiro;Nakajinia, Makoto;Yonehara, Toshiro
幕下卒中引起的失语症很少有报道，其机制尚未完全确定。我们评估了两名因急性缺血性中风而入住日本熊本县生力会熊本医院的患者，以确定他们的失语症是否由幕下中风引起。第1例患者，59岁男性，有左顶叶栓塞性卒中病史，伴有非常轻度的命名障碍后遗症，卒中导致Wernicke失语症、言语不流利和右肢共济失调。第二例患者，76岁女性，有慢性肾功能衰竭病史，卒中导致经皮质感觉性失语和右侧1.5综合征。两名患者的近期缺血性病变均限于右小脑半球和中脑的右内侧部分。然而，SPECT显示两名患者的左大脑半球的低摄取病变，不包括最近的缺血性病变，但已扩散到难以用旧的或最近的缺血性病变解释的程度，这可能是他们最近失语症的原因。我们认为这两个病人的失语症可能是由交叉小脑-大脑功能不能引起的。
Aphasia induced by an infratentorial stroke has rarely been reported, and its mechanism has not been fully identified. We evaluated two individuals who had been admitted to Saiseikai Kumamoto Hospital in Kumamoto, Japan, due to acute ischemic stroke in order to determine whether their aphasia was induced by an infratentorial stroke. The first patient, a 59-year-old man with a history of left parietal embolic stroke with very mild sequelae of anomia, developed Wernicke's aphasia, nonfluent speech, and right limb ataxia as a result of the stroke. The second patient, a 76-year-old woman with a history of chronic renal failure, experienced transcortical sensory aphasia and right one-and-a-half syndrome as a result of the stroke. Both patients' recent ischemic lesions were limited to the right cerebellar hemisphere and the right medial portion of the midbrain. However, SPECT showed low-uptake lesions in both patients' left cerebral hemisphere that did not include the recent ischemic lesions but that had spread to an extent that was difficult to be explained by the old or recent ischemic lesions and that might be responsible for their recent aphasia. We believe that the aphasia experienced by these two patients may have been caused by crossed cerebello-cerebral diaschisis.