Godefroy O, Dubois C, Debachy B, Leclerc M, Kreisler A
Department of Neurovascular Disorders of Lille and Institut d'Orthophonie de Tours, Amiens, France.
Stroke. 2002 Mar;33(3):702-5. doi: 10.1161/hs0302.103653.
Aphasia is frequent in stroke patients and is associated with poor prognosis. However, characteristics and determinants of vascular aphasias remain controversial. The aim of this study was to evaluate aphasia characteristics at the acute stage in patients admitted to a stroke unit.
The study was performed in 308 patients consecutively assessed with a standardized aphasia battery.
Aphasia was observed in 207 patients; global and nonclassified aphasias accounted for 50% of aphasic syndromes at the acute stage, whereas classic aphasias (Wernicke's, Broca's, transcortical, and subcortical aphasias) were less frequent. Age differed across aphasic syndromes in ischemic stroke patients only; patients with conduction aphasia were younger, and patients with subcortical aphasia were older. Sex did not significantly differ across aphasic syndromes. The presence of a previous stroke was more frequent in nonclassified aphasia.
This study shows (1) that vascular aphasias are frequently severe or nonclassic at the acute stage, a finding explained in part by the presence of a previous stroke; (2) that the age effect is due mainly to its influence on infarct location; and (3) that the main determinant of aphasia characteristics is lesion location.
失语在中风患者中很常见，且与预后不良相关。然而，血管性失语的特征和决定因素仍存在争议。本研究的目的是评估入住中风单元的患者急性期的失语特征。
对308例患者连续进行标准化失语成套测验。
207例患者出现失语；急性期失语综合征中，完全性失语和未分类失语占50%，而典型失语（韦尼克失语、布罗卡失语、经皮质失语和皮质下失语）较少见。仅在缺血性中风患者中，失语综合征的年龄存在差异；传导性失语患者较年轻，皮质下失语患者较年长。不同失语综合征的性别差异不显著。既往有中风史在未分类失语中更为常见。
本研究表明：（1）血管性失语在急性期常为重度或非典型，部分原因是既往有中风史；（2）年龄效应主要是因其对梗死部位的影响；（3）失语特征的主要决定因素是病变部位。
