Hyodo A, Maki Y, Nakagawa K, Enomoto T, Akimoto H
No Shinkei Geka. 1979 Aug;7(8):791-6.
Crossed aphasia, first described by Bramwell, is aphasia due to the hemispheric damage on the side of handedness. Crossed aphasia in a dextral is rare, and in Japan, there have not been more than ten cases in which the lesion is localized clearly. The cases reported till now have been verified mainly by necropsy. However, the time lag between the appearance of aphasia and the necropsy may affect the conclusion subtly. We consider that computed tomography (CT) can obtain almost the same findings as that by necropsy. However, at present there have been few cases diagnosed by CT except two cases reported by April et al. and Wechsler. We have reported a 47-year-old man in a dextral, who shows left hemiparesis and Broca's aphasia. His lesion is diagnosed by cerebral angiography and CT as the right hemisphere infarction due to right middle cerebral artery occlusion. CT localizes the lesion on the right hemisphere mainly sited deep region and sited wedge shaped cortical area of the fronto-parietal region. On the other hand, it localizes no lesion on the left hemisphere. CT in aphasia has been already reported by Hayward et al. In their report they concluded that correlation of lesion located by CT with aphasia type supported Geschwind's concept of aphasia. In this report we have discussed CT in crossed aphasia analysing our case and the two cases by April et al. and Wechsler. Three cases including our case are all Broca's aphasia, and we compare the lesion location of these three cases with Hayward's lesion located on Broca's aphasia. As the result of this, we can draw the conclusion that the lesion location by CT of these three cases and that of Hayward's report are almost symmetric.
交叉性失语症最早由布拉姆韦尔描述，是由于优势手侧半球受损所致的失语症。右利手者出现交叉性失语症较为罕见，在日本，病变定位明确的病例不超过十例。到目前为止报道的病例主要通过尸检得到证实。然而，失语症出现与尸检之间的时间间隔可能会对结论产生微妙影响。我们认为计算机断层扫描（CT）能够获得与尸检几乎相同的结果。然而，目前除了阿普里尔等人和韦克斯勒报道的两例外，很少有通过CT诊断的病例。我们曾报道过一名47岁的右利手男性，他表现出左侧偏瘫和布罗卡失语症。通过脑血管造影和CT诊断其病变为右侧大脑中动脉闭塞导致的右半球梗死。CT将病变定位在右半球，主要位于深部区域以及额顶叶的楔形皮质区域。另一方面，左半球未发现病变。海沃德等人已经报道过失语症患者的CT情况。在他们的报告中，他们得出结论，CT定位的病变与失语症类型的相关性支持了杰施温德的失语症概念。在本报告中，我们通过分析我们的病例以及阿普里尔等人和韦克斯勒的两例病例来讨论交叉性失语症的CT情况。包括我们的病例在内的三例均为布罗卡失语症，我们将这三例的病变位置与海沃德报道的布罗卡失语症患者的病变位置进行了比较。结果是，我们可以得出结论，这三例病例的CT病变位置与海沃德报告的病变位置几乎对称。
