Aphasia with predominantly subcortical lesion sites: description of three capsular/putaminal aphasia syndromes.
Aphasia with predominantly subcortical lesion sites: description of three capsular/putaminal aphasia syndromes.
复制标题
以皮质下病变部位为主的失语症：三种囊膜/壳核失语症综合征的描述。
作者：
M. Naeser;M. Alexander;N. helm;H. Levine;S. Laughlin;N. Geschwind
本文报告了9例皮质下失语症的CT表现。病因为血管闭塞8例，出血1例。观察到三种皮层下失语综合征和三种C/P病变部位模式。C/P病变部位伴有前上白质病变扩展的患者理解力、语法良好，但言语缓慢、构音障碍，并持续右侧偏瘫。C/P病变部位伴后白质病变延伸至颞峡部听觉放射线的患者理解力差，韦尼克型言语流利，右侧偏瘫持续。C/P病变部位既向前上又向后延伸的患者出现全面失语，并有持续的右侧偏瘫。虽然这些C/P皮质下失语症的病例与Broca和Wernicke皮质性失语症综合征的某些众所周知的特征相同，但它们在神经学表现、CT扫描病变部位或语言行为方面并不完全类似于Broca、Wernicke、全局性或丘脑性失语症的病例。与这些C/P病变部位相关的皮质下失语症的进一步研究似乎是必要的。
Nine cases of subcortical aphasia with capsular/putaminal (C/P) lesion sites demonstrated on computed tomographic (CT) scans were studied. Eight cases were occlusive-vascular in etiology and one was hemorrhagic. Three subcortical aphasia syndromes and three C/P lesion site patterns were observed. Patients with C/P lesion sites with anterior-superior white-matter lesion extension had good comprehension, grammatical, but slow, dysarthric speech, and lasting right hemiplegia. Patients with C/P lesion sites with posterior white-matter lesion extension across the auditory radiations in the temporal isthmus had poor comprehension, fluent Wernicke-type speech, and lasting right hemiplegia. Patients with C/P lesion sites with both anterior-superior and posterior extension were globally aphasic and had lasting right hemiplegia. Although these cases of C/P subcortical aphasia shared certain well-known features of Broca's and Wernicke's cortical aphasia syndromes, they did not completely resemble cases of either Broca's, Wernicke's, global, or thalamic aphasia in neurologic findings, CT scan lesion sites, or language behavior. Further study of the subcortical aphasias associated with these C/P lesion sites seems to be warranted.