Puel M, Demonet J F, Cardebat D, Bonafé A, Gazounaud Y, Guiraud-Chaumeil B, Rascol A
Rev Neurol (Paris). 1984;140(12):695-710.
Twenty five cases of subcortical aphasia of vascular origin (15 haemorrhagic, 10 ischaemic), have been studied in detail by means of neurolinguistic and brain-scanning approaches. The neurolinguistic investigation allowed three groups to be distinguished. Group 1 comprised 4 cases of dysarthria. Group 2 was made up of 9 classical syndromes of aphasia: 2 global aphasias, 3 Broca's aphasias, 3 cases of Wernicke's aphasia and 1 case of conduction aphasia. Group 3 consisted in 12 unusual aphasic syndromes, i.e. 2 mixed aphasias and 10 cases which did not correspond with any traditional semiological description and are spoken of as "dissident" (or anomalous) cases. The CT scan results revealed a wide range of focal lesions for the same clinical syndrome; the 10 "dissident" cases were, in particular, associated with a large variety of lesions. After a discussion of the anatomical limits of the subcortical lesions, 2 points emerge: 1) in the current state of technological experience no anatomo-clinical correlation can be drawn as regards language-deficiencies of subcortical origin. 2) in almost half the cases a "unique" syndrome of aphasia has been observed and described, which at first might suggest the diagnosis of a subcortical lesion.
我们采用神经语言学和脑部扫描方法，对25例血管源性皮质下失语症患者（15例出血性，10例缺血性）进行了详细研究。神经语言学调查区分出了三组。第一组包括4例构音障碍患者。第二组由9例经典失语综合征组成：2例完全性失语、3例布罗卡失语、3例韦尼克失语和1例传导性失语。第三组有12例特殊失语综合征，即2例混合性失语和10例不符合任何传统症状学描述的病例，这些病例被称为“不一致”（或异常）病例。CT扫描结果显示，相同临床综合征对应的局灶性病变范围广泛；特别是10例“不一致”病例与多种病变相关。在讨论了皮质下病变的解剖学界限后，出现了两点：1）在目前的技术经验水平下，无法就皮质下起源的语言缺陷得出解剖学与临床的相关性。2） 在几乎一半的病例中，观察到并描述了一种“独特”的失语综合征，起初可能提示诊断为皮质下病变。
