Prognosis in aphasia and CT localization and lesion size

The influence of CT localization and lesion size on the prognosis of aphasia was studied in 76 right-handed aphasic patients who had had a cerebrovascular accident. On the basis of the results of the accumulated lesions with many Broca and Wernicke aphasics, the highly involved sites were determined to be the Broca area and the Wernicke area. The CT lesions of 76 aphasics were traced in the total area, the Broca area, and the Wernicke area; these were termed the total lesion, the Broca lesion, and the Wernicke lesion respectively. The digitizer program was used to determine the size of the lesions by tracing them onto standardized martrices, which were divided into 3000 points and which corresponded to the CT slices. The recovery rates were determined by comparing the scores of 2 SLTA (Standard Language Test of Aphasia) tests given at 3-month intervals in order to coincide with the clinical impressions. These recovery rates were used as an indication of the prognosis. The results obtained were as follows: (1) Negative correlations between the sizes of the total area and the Broca area and the recovery rates were observed, while no correlation was observed between the size of the Wernicke area and the recovery rates. These findings indicate that the larger the lesions in the total area and the Broca area, the less overall recovery occurs in the total language deficit. (2) Negative correlations between the size of each area and the recovery rates in expressive aspects, namely, ''speaking'' and ''writing,'' were observed, but not in the receptive aspects, namely, ''hearing'' and ''reading,'' or in ''calculation.'' (author)