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Aphasia due to stroke

Daniel L Moellentin, Dale Stewart, James Barbour
A 39-year-old man presented with new onset right hemiparesis and aphasia within an hour of using approximately 120 mL lidocaine 4% topical solution intranasally. Lidocaine had been prescribed over a 3-week period for pain due to multiple debridements of the nasal septum. A total of 650 mL of 4% lidocaine (26 g) had been dispensed to the patient during this time. The patient had a significant history of drug abuse, including snorting crushed tablets. Otherwise he was a healthy man with no chronic diseases or conditions...
September 2016: Hospital Pharmacy
Siham Zahi, Laila Mahir, Herman Azanmasso, Fatima Lmidmani, Abdellatif El Fatimi
OBJECTIVE: Depression affects many people following their stroke (between 30 and 60%). It can occur in the days following the attack but several years later. Our objective was to investigate the incidence of depression and anxiety in our patients after stroke followed for post-stroke hemiplegia. MATERIAL/PATIENTS AND METHODS: Prospective study over 6 months from 10 September 2014 to 10 March 2015. It covered all cases of stroke supported the MPR service during this period were excluded patients with severe aphasia...
September 2016: Annals of Physical and Rehabilitation Medicine
R Darkow, A Flöel
Speech and language therapy is essential in the rehabilitation of aphasic disorders following a stroke. Due to the predicted increase of aphasia and limited resources within the healthcare system, the development of efficient and sustainable treatment methods is of exceptional importance. The effectiveness of both traditional and innovative approaches needs to be evaluated against the standards of evidence-based medicine. Class I evidence has been established for high-intensity speech and language therapy in subacute and chronic stages of aphasia...
October 2016: Der Nervenarzt
Donald D Kautz, Elizabeth R Van Horn
PROBLEM: The sequelae of a stroke can negatively affect sex and intimacy for survivors and their partners. PURPOSE: This clinical article offers practical evidence-based recommendations for nurses to use in advising couples who may be experiencing sexual problems due to decreased desire, erectile dysfunction, vaginal dryness, paraparesis, pain, spasticity, fatigue, aphasia, concrete thinking, emotional lability, shame, embarrassment, fear, depression, or neurogenic bladder...
September 9, 2016: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
Alex Gonzalez-Bossolo, Alexis Gonzalez-Rivera, Santiago Coste-Sibilia
Thyroid storm is a life-threatening condition that occurs secondary to an uncontrolled hyperthyroid state. Atrial fibrillation is a cardiovascular complication occurring in up to 15% of patients experiencing thyroid storm, and if left untreated this condition could have up to a 25% mortality rate. Thyroid storm with stroke is a rare presentation. This case report details a left middle cerebral artery (MCA) stroke with global aphasia and thyroid storm in a 53-year-old Hispanic male patient. Although uncommon, this combination has been reported in multiple case series...
2016: Case Reports in Endocrinology
Sarah Northcott, Alan Simpson, Becky Moss, Nafiso Ahmed, Katerina Hilari
BACKGROUND: The psychosocial impact of stroke and aphasia is considerable. AIMS: To explore UK speech-and-language therapists' (SLTs) clinical practice in addressing the psychological and social needs of people with aphasia, including their experiences of working with mental health professionals. METHODS & PROCEDURES: A 22-item online survey was distributed to UK SLTs via the British Aphasiology Society mailing list and Clinical Excellence Networks...
September 4, 2016: International Journal of Language & Communication Disorders
Shin Saito, Seigo Shindo, Shun Tsudaka, Kazutaka Uchida, Manabu Shirakawa, Shinichi Yoshimura
Here we report first 2 cases of patients with nonvalvular atrial fibrillation with acute cardioembolic stroke in whom thrombi in the left atrial appendage (LAA) were resolved by edoxaban administration. Case 1 reports an 86-year-old woman who suddenly showed right hemiparesis and aphasia due to occlusion of the left middle cerebral artery. She received mechanical thrombectomy and recovered neurologically. Transesophageal echocardiography (TEE) performed on day 1 demonstrated thrombus in the LAA. The thrombus was resolved on day 13 after initiation of edoxaban (30 mg once daily) instead of warfarin, which was administered before stroke onset...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Francesco Biraschi, Francesco Diana, Francesco Alesini, Giulio Guidetti, Simone Peschillo
A 75-year-old man with hypertension and atrial fibrillation was admitted to our emergency room with right-sided hemiplegia and complete aphasia (National Institutes of Health Stroke Scale [NIHSS] score = 18). A noncontrast computed tomography scan showed a slight hypodensity in the left insular region and a bright hyperdense sign in the M1 tract of the left middle cerebral artery (MCA). Angio-CT confirmed an occlusion of the M1 tract of the MCA. Magnetic resonance diffusion-weighted imaging/perfusion-weighted imaging was obtained and revealed a mismatch in the left parietal cortical region...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Alexander Thiel, Anna Zumbansen
BACKGROUND: Post-stroke aphasia syndromes as a clinical entity arise from the disruption of brain networks specialized in language production and comprehension due to permanent focal ischemia. This approach to post-stroke aphasia is based on two pathophysiological concepts: 1) Understanding language processing in terms of distributed networks rather than language centers and 2) understanding the molecular pathophysiology of ischemic brain injury as a dynamic process beyond the direct destruction of network centers and their connections...
June 13, 2016: Restorative Neurology and Neuroscience
Maria V Ivanova, Dmitry Yu Isaev, Olga V Dragoy, Yulia S Akinina, Alexey G Petrushevskiy, Oksana N Fedina, Victor M Shklovsky, Nina F Dronkers
A growing literature is pointing towards the importance of white matter tracts in understanding the neural mechanisms of language processing, and determining the nature of language deficits and recovery patterns in aphasia. Measurements extracted from diffusion-weighted (DW) images provide comprehensive in vivo measures of local microstructural properties of fiber pathways. In the current study, we compared microstructural properties of major white matter tracts implicated in language processing in each hemisphere (these included arcuate fasciculus (AF), superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF), inferior frontal-occipital fasciculus (IFOF), uncinate fasciculus (UF), and corpus callosum (CC), and corticospinal tract (CST) for control purposes) between individuals with aphasia and healthy controls and investigated the relationship between these neural indices and language deficits...
May 4, 2016: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Zaitao Yu, Xiang'en Shi, Hai Qian, Fangjun Liu, Zhongqing Zhou, Yuming Sun, Yang Yang
OBJECTIVE: To evaluate the effectiveness of internal maxillary artery (IMA) - radial artery graft (RAG) - middle cerebral artery (MCA) bypass surgery for chronic arterial-sclerotic severe stenosis or occlusion of the internal carotid artery (ICA) or MCA. METHODS: A retrospective study was conducted in 31 patients with ischemic cerebrovascular disease who underwent bypass surgery of the IMA with a RAG of the MCA. Twenty-seven patients had complete occlusion of the ICA or MCA, and four patients had severe stenosis of the M1 segment of the MCA...
May 2016: Neurological Research
I P Martins, J Fonseca, J Morgado, G Leal, L Farrajota, A C Fonseca, T P Melo
OBJECTIVES: Language recovery following acute stroke is difficult to predict due to several evaluation factors and time constraints. We aimed to investigate the predictors of aphasia recovery and to identify the National Institute of Health and Stroke Scale (NIHSS) items that best reflect linguistic performance, 1 week after thrombolysis. MATERIALS AND METHODS: We retrieved data from a prospective registry of patients with aphasia secondary to left middle cerebral artery (MCA) stroke treated with intravenous thrombolysis...
April 21, 2016: Acta Neurologica Scandinavica
Paul G Mathew, Regina Krel, Bhuvin Buddhdev, Hossein Ansari, Shivang G Joshi, Warren D Spinner, Brad C Klein
BACKGROUND: Patients with basilar migraine (BM) and hemiplegic migraine (HM) have been excluded from triptan and DHE clinical trials due to a potential risk of ischemic vascular events, and the FDA mandates that package labeling state that they are contraindicated in BM and HM. The objective of this study was to demonstrate that triptans and DHE can be used for the abortive treatment of BM and HM without significant adverse ischemic vascular events. METHODS: A retrospective chart review of patients with BM features or HM who received acute abortive treatment with either triptans or DHE was conducted at 4 headache centers to assess the frequency of ischemic vascular events after administration...
April 8, 2016: Headache
Claudia Aramendi, Alain Cubero, Andrés Cortés, Daniel Rivas, Alejandro Crespo, José I Aramendi
A 54-year-old man presented with unstable angina and stroke with right hemiplegia and aphasia due to left main coronary plus 3-vessel disease, severe stenosis of bilateral internal carotid, proximal left common carotid, and proximal left subclavian arteries. Simultaneous complete revascularization was undertaken with the use of conventional cardiopulmonary bypass and moderate hypothermia (25℃). The left internal mammary artery and two saphenous vein grafts were used for coronary artery bypass, and brain revascularization consisted of a left aorta-to-common carotid Dacron graft and bilateral carotid endarterectomy...
September 2016: Asian Cardiovascular & Thoracic Annals
Marcus Meinzer, Robert Darkow, Robert Lindenberg, Agnes Flöel
Transcranial direct current stimulation has shown promise to improve recovery in patients with post-stroke aphasia, but previous studies have only assessed stimulation effects on impairment parameters, and evidence for long-term maintenance of transcranial direct current stimulation effects from randomized, controlled trials is lacking. Moreover, due to the variability of lesions and functional language network reorganization after stroke, recent studies have used advanced functional imaging or current modelling to determine optimal stimulation sites in individual patients...
April 2016: Brain: a Journal of Neurology
Muhammad Taimoor Khan, Ann Murray, Matthew Smith
BACKGROUND: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is considered a common cause of hereditary stroke caused by mutation of the NOTCH3 gene. Evidence against the use of intravenous tissue plasminogen activator (IV tPA) has been suggested due to possibility of hemorrhage. We present a case of a patient with CADASIL who was successfully treated using IV tPA. METHODS: A case description of a female patient who presented with stroke-like symptoms was a previously known case of CADASIL...
April 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Taku Uchiyama, Hiroaki Okamoto, Motofumi Koguchi, Yutaka Tajima, Kenji Suzuyama
Aplastic or twig-like middle cerebral artery (Ap/T-MCA) is a rare anatomical anomaly, which can be associated with intracranial hemorrhage and cerebral ischemia. A 52-year-old woman who presented with sudden headache was admitted to our hospital. Computed tomography (CT) and magnetic resonance imaging showed no abnormality; however, magnetic resonance angiogram revealed an occlusion or severe stenosis in the left middle cerebral artery. Three-dimensional CT angiography demonstrated severe stenosis in the left middle cerebral artery...
February 2016: No Shinkei Geka. Neurological Surgery
Boram Lee, Hyun Im Moon, Sung Hee Lim, Hyesuk Cho, Hyunjoo Choi, Sung-Bom Pyun
Few studies have investigated language recovery patterns and the mechanisms of crossed bilingual aphasia following a subcortical stroke. In particular, Korean-Japanese crossed bilingual aphasia has not been reported. A 47-year-old, right-handed man was diagnosed with an extensive right basal ganglia hemorrhage. He was bilingual, fluent in both Korean and Japanese. After his stroke, the patient presented with crossed aphasia. We investigated changes in the Korean (L1) and Japanese (L2) language recovery patterns...
June 2016: Neurocase
Ezequiel Gleichgerrcht, Julius Fridriksson, Chris Rorden, Travis Nesland, Rutvik Desai, Leonardo Bonilha
BACKGROUND: Representations of objects and actions in everyday speech are usually materialized as nouns and verbs, two grammatical classes that constitute the core elements of language. Given their very distinct roles in singling out objects (nouns) or referring to transformative actions (verbs), they likely rely on distinct brain circuits. METHOD: We tested this hypothesis by conducting network-based lesion-symptom mapping in 38 patients with chronic stroke to the left hemisphere...
2016: NeuroImage: Clinical
Leandro Valiengo, Roberta Casati, Nadia Bolognini, Paulo A Lotufo, Isabela M Benseñor, Alessandra C Goulart, André R Brunoni
Aphasia is a common consequence of stroke; it is estimated that about two-thirds of aphasic patients will develop depression in the first year after the stroke. Treatment of post-stroke depression (PSD) is challenging due to the adverse effects of pharmacotherapy and difficulties in evaluating clinical outcomes, including aphasia. Transcranial direct current stimulation (tDCS) is a novel treatment that may improve clinical outcomes in the traditionally pharmacotherapy-refractory PSD. Our aim was to evaluate the safety and efficacy of tDCS for patients with PSD and with aphasia...
2016: Neurocase
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