Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2024
[Clinical and tomographic comparisons in patients with aphasia in the acute period of ischemic stroke].
СтатьяСравнительное исследованиеАннотация на английскомНазвание и аннотация: Оригинал на русском
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Kotov S V, Zenina V A, Stepanova E A, Isakova E V, Shcherbakova M M
Аннотация
OBJECTIVE: To investigate the structural damage in patients with aphasia in the acute phase of ischemic stroke using X-ray computed tomography (CT) scans of the brain.
MATERIAL AND METHODS: We examined 65 right-handed individuals in the acute stage of ischemic stroke in the left middle cerebral artery, including 39 men and 26 women aged 41 to 87 years. The patients were divided into two groups: those with aphasia (group 1, n=48) and those without aphasia (group 2, n=17). All participants underwent head CT scans on the first day of hospitalization and again 24 to 48 hours later, as well as CT angiography of the intracranial and brachiocephalic arteries.
RESULTS: Atherothrombotic and cardioembolic pathogenic subtypes of ischemic stroke were significantly more common in group 1, while lacunar subtypes were more common in group 2 (χ2=13.608, p=0.004). Most patients had a mild to moderate stroke, but the severity and degree of disability were significantly greater in group 1. There was also a significant difference in the size of cerebral infarction (25.7±19.9 versus 3.1±3.5 cm³, p<0.001). More than 75% of patients in group 1 had lesions in speech representation areas and adjacent regions of the left cerebral cortex, and more than 90% had involvement of the speech network tracts within the infarction zone (compared to 0 and 11.8% in group 2, respectively, p<0.001).
CONCLUSION: The results confirm the role of speech disorders in the level of disability after ischemic stroke. The significance of damage to both cortical representations and the conductors of the speech network is shown. This can affect the prognosis for speech function restoration, as well as allowing for personalized modeling of a rehabilitation program for these patients.
MATERIAL AND METHODS: We examined 65 right-handed individuals in the acute stage of ischemic stroke in the left middle cerebral artery, including 39 men and 26 women aged 41 to 87 years. The patients were divided into two groups: those with aphasia (group 1, n=48) and those without aphasia (group 2, n=17). All participants underwent head CT scans on the first day of hospitalization and again 24 to 48 hours later, as well as CT angiography of the intracranial and brachiocephalic arteries.
RESULTS: Atherothrombotic and cardioembolic pathogenic subtypes of ischemic stroke were significantly more common in group 1, while lacunar subtypes were more common in group 2 (χ2=13.608, p=0.004). Most patients had a mild to moderate stroke, but the severity and degree of disability were significantly greater in group 1. There was also a significant difference in the size of cerebral infarction (25.7±19.9 versus 3.1±3.5 cm³, p<0.001). More than 75% of patients in group 1 had lesions in speech representation areas and adjacent regions of the left cerebral cortex, and more than 90% had involvement of the speech network tracts within the infarction zone (compared to 0 and 11.8% in group 2, respectively, p<0.001).
CONCLUSION: The results confirm the role of speech disorders in the level of disability after ischemic stroke. The significance of damage to both cortical representations and the conductors of the speech network is shown. This can affect the prognosis for speech function restoration, as well as allowing for personalized modeling of a rehabilitation program for these patients.