[Aphasia in acute apoplexy. Incidence, background factors and course].

Knowledge of the frequency and remission of aphasia is essential for the rehabilitation of stroke patients. Information on its determinants provides insight on brain organization of language. Therefore, a community based sample of 881 unselected, acute stroke patients was studied prospectively and consecutively. Assessment of aphasia was done on admission, weekly during hospital stay, and again at a six-month follow-up using the aphasia score of the Scandinavian Stroke Scale. Thirty-eight percent had aphasia at the time of admission, while at discharge it was 18%. Sex was not a significant determinant of aphasia in stroke, and no sex difference was found in the anterior-posterior distribution of lesions causing aphasia. There was, however, a higher rate of women with aphasia with right-sided lesions. The remission curve was steep: stationary language function in 95% was reached within two weeks in those with initial mild aphasia, within six weeks with moderate, and within ten weeks with severe aphasia. Initial severity of aphasia was the only clinically relevant predictor of aphasia outcome in multiple linear regression analysis. Sex, handedness, and side of stroke lesion were not independent outcome predictors, and the influence of age was minimal.