Havezova, L.

Jordanova, P.

English

Varna Medical University Press: Journals

Scripta Scientifica Medica, vol.28, Suppl.1,pp.219-220 Copyright © Medical University, Varna, 1991 P E E C H D I S T U R B A N C I E S IN H E M O R R H A G I C S T R O K E OF T H E D O M I N A N T H E M I S P H E R E P . J o r d a n o v a , L. H a v e z o v a Department of Neurology, Varna The study of speech deficiencies in hemorrhagic cerebral insults of the dominant hemisphere offers the oppor tuni ty to discuss speech p a t h o l o g y in les ions of the deep s u b c o r t i c a l b ra in s t ruc tu res (1,2,5,6). The main purpose of this study is to fo l low-up the dynamic changes of speech disorders of hemorrhagic strokes of the left he-misphere in the early recovery period and their type as compared to the localization of the haematoma. Fifteen patients have been assessed (8 men and 7 women) by a standard neuropsychological test, CT and neurological investigation. In the acute recovery period (ARP) ( 1 s t - 3 r d day) 86% of the patients have been assessed, in the early recovery period (ERP) ( 3 r d d a y - 2 n d month) - 100% and in the late recovery period (LRP) (after the 2 n d month) - 36%. The type of aphatic lesions is defined after the classi-f icat ion of Luria (1969) and their class is determined as mi ld, moder-ate and severe. There are certain dymanic changes in aphatic lesions in the var i -ous recovery periods. Two patients showed dysarthria and non-modulated speech. The localization of haematoma in the latter is respectively in the thalamus and deep parietally. Dysarthria cases in thalamic hemorrhage of this type are reported by Schuster (5). Table 1 presents the variety of speech disorders in the temporal lobe where the number of cases of moderate and severe aphasia is the greatest one. Localization Type of aphasia Total of lesion ETA ATA Type 1 Type 2 Dysarthria L. frontalis 1 1 L. temporal is 1 4 1 1 7 L. parietalis 1 1 2 L occipital is 1 1 Basal ganglia 3 1 4 Total 5 4 2 2 2 15 220 The low number of cases in the other lobes is not enough to al low reliable stat ist ical interpret ion. In the acute recovery period an equally severe lesion of the motor and sensory speech functions was observed and a rapid and signif icant recovery as well . The increased volume of the hemorrhagic zone and its surface distr ibution increase the severity of aphasia (2-4). The lesions of the same brain structures in various patients may cause aphasia of different types and severity. In lesions of the deep subcort ical structures major opportunity for re-covery of the speech functions are preserved (3). By the same loca-t ion of cerebral hemorrhage rare dysarthric phenomena may also be observed (5). The correlat ion between the CT and neuropsychologi-cal assessment in aphasia shows contradictory opportunit ies for type definit ion of aphasia and can bear a prognostic value for re-covery (6). We conclude t h a t : 1. The localization of the haematoma does not affect the type of aphatic disorders. 2. The lesion of the deep subcort ical structures may lead to aphatic disorders presented as fragmented speech, lowered speech initiative and possible signs of dysarthria. REFERENCES: L L u r i a A. Higher cor tex funct ions in man. M., 1969 in Russ). 2. Stoliarova L. Aphasia in cortex stroke patients. M.,1973 (in Russ). 3. Stoliarova L , J.Varkin. Zh. nevropatol. psi-hiatr. 1985,9,1296-1300 (in Russ). 4. Demeurisse G., A C a r o n . Eur. Neurol.,24,1985,134-139. 5. Ciemius V. Neurology,20,1970,776-778. 6. Naeser M., R.Hayard. Arch. Neurol.,36,1979,233-235. 

PEECH DISTURBANCIES IN HEMORRHAGIC STROKE OF THE DOMINANT HEMISPHERE

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PEECH DISTURBANCIES IN HEMORRHAGIC STROKE OF THE DOMINANT HEMISPHERE

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