Objective: To study the effect of cerebral ischemic vascular insult on the localization of language areas as regard to automatic speech, initiation, and mutism. Materials and Methods: Seventy ischemic stroke patients were selected within the first 48 h of the onset of stroke with left hemispheric stroke with aphasia. Inclusion criteria: any age above seven years, both sexes, first ever clinical stroke, admitted within the first 2 days of stroke insult. Patients underwent careful history taking, neurological examination, routine laboratory investigations, echo cardiography, and carotid duplex and language assessments. Results: Automatic speech disorders were mainly seen along left insular, left supramarginal and left frontal inferior orbital lesions. Initiation difficulty is seen mainly along as left insular, left temporal superior and left periventricular lesions. Mutism is seen along left external capsule, left internal capsule, left pallidum, left frontal inferior orbital and left inferior trigone lesions. Conclusions: Deep periventricular white matter and insular area in the dominant hemisphere play an important role in many language tasks. Thus aphasia is not a mere cortical function.
Cite this paper
Dwidar, A. , Alloush, T. , El-Ella, M. , Ahmed, N. , Maher, K. , Nada, M. and Ibrahim, M. (2014) Clinical and Radiological Localization of Language Dysfunctions in Acute Ischemic Stroke. Open Journal of Medical Imaging
, 80-85. doi: 10.4236/ojmi.2014.42011
 Kirshner, H.S. and Jacobs, D. (2008) eMedicine Specialties. http://emedicine.medscape.com/article/1135944-overview
 Spreen, O. and Risser, A.H. (2003) Assessment of Aphasia. Oxford University Press, New York, 45-49.
 Hillis, A.E. (2007) Aphasia: Progress in the Last Quarter of a Century. John Hopkins University School of Medicine, Baltimore. (Supported by NIH (NIDCD) from AAN Enterprises, Inc.)
 Emam, A. (2003) The Diagnostic role of Neuroradiology in Dysphasic Patients. Ain Shams University, Cairo.
 Kreisler, A., Godefroy, O., Delmaire, C., et al. (2000) The Anatomy of Aphasia Revisited. Neurology, 54, 1117-1123.
 Blank, S.C., Scott, S.K., Warburton, E., et al. (2002) Speech Production: Wernicke, Broca and Beyond. Brain, 125, 1829-1838. (Quoted from Rohrer et al., 2008)
 Kirzinger, A. and Jurgens, U. (1982) Cortical Lesion Effects and Vocalization in the Squirrel Monkey. Brain Research, 223, 299-315.
 Jurgens, V. (1984) The Efferent and Afferent Connections of the Supplementary Motor Area. Brain Research, 300, 63-81.
 Rohrer, J.D., Knight, W.D., Warren, J.E., et al. (2008) Word Finding Difficulty: A Clinical Analysis of the Progressive Aphasias. Brain, 131, 8-38. http://dx.doi.org/10.1093/brain/awm251