Aphasia following Striatocapsular Infarction May Be Explained by Concomitant Small Cortical Infarct on Diffusion-Weighted Imaging

Vol. 19, No. 4, 2005

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Original Paper

Aphasia following Striatocapsular Infarction May Be Explained by Concomitant Small Cortical Infarct on Diffusion-Weighted Imaging
Moon-Ku Han^a, Dong-Wha Kang^b, Sang-Wuk Jeong^c, Jae-Kyu Roh^d

^aDepartment of Neurology, Seoul National University Bundang Hospital, Seongnam,
^bDepartment of Neurology, University of Ulsan, Asan Medical Center, Seoul,
^cDepartment of Neurology, Inje University, Ilsan Paik Hospital, Ilsan,
^dDepartment of Neurology, Seoul National University Hospital, Seoul, Korea

Address of Corresponding Author

Cerebrovasc Dis 2005;19:220-224 (DOI: 10.1159/000083886)

Key Words

Striatocapsular infarction
Aphasia
Magnetic resonance imaging
Diffusion-weighted imaging

Abstract

Background: The underlying mechanism of aphasia following striatocapsular infarction (SCI) remains controversial. We hypothesized that aphasia resulting from SCI might be associated with concomitant cortical lesions, which can be demonstrated by diffusion-weighted imaging (DWI). Methods: We analyzed 24 patients with left SCI who underwent DWI and MR angiography within 2 days after the onset. Aphasia was assessed by the modified Korean version of the Boston Diagnostic Aphasia Examination test. Results: DWI showed the presence of additional ischemic lesions involving the cortical areas in 13 of 24 SCI patients (54%). Ten patients (42%) showed aphasia. All 10 patients with aphasia had cortical lesions in addition to SCI (p = 0.0002), whereas 21% (3/14) of the nonaphasic patients had additional cortical lesions. Conventional MRI did not reveal the presence of corresponding acute cortical lesions in any of the aphasic patients. There was no difference between the patients with and without aphasia in terms of their stroke etiology. Conclusions: Our data suggest that aphasia due to SCI in the acute stage may be attributed to direct cortical injury, whose presence can be demonstrated by DWI, even though it might be invisible on conventional imaging.

Author Contacts

Jae-Kyu Roh, MD, PhD
Department of Neurology, Seoul National University Hospital
28 Yongon-Dong
Chongno-Gu, Seoul, 110-744 (South Korea)
Tel. +82 2 760 3265, Fax +82 2 3672 4949, E-Mail rohjk@snu.ac.kr

Article Information

Received: February 2, 2004
Accepted: October 5, 2004
Published online: February 8, 2005
Number of Print Pages : 5
Number of Figures : 1, Number of Tables : 1, Number of References : 28

Medline Abstract (ID 15703465)

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