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Aphasia and cerebral haemodynamic changes measured by TCD in patients with stroke

The association of cerebrovascular disease and aphasia is well known. Cerebral haemodynamic changes are considered to play an important role in etiology of aphasia. The exact changes in cerebrovascular haemodynamics causing the aphasia in patients with stroke is still unknown. The patients were evaluated by clinical neurological examination and brain CT scan. Duplex ultrasound imaging of extracranial and intracranial blood vessels was performed in each patient. We measured cerebral blood flow velocity in first 7 days after the onset and after 3 months. Speech deficit characterization was performed by speech-language patologists determined protocol. We used teh Boston Diagnostic Examination of Aphasia. We found that all the cases of the Broca's aphasia and most of the global aphasia were in the group of the young patients. Patients with Wernicke.'s aphasia were both in the group of the young and old patients but higher percentage was in the group of the older patients. We observed 20 patients with ischemic lesions of the brain, with neurological deficit and with comunication disorder. We measured blood flow velocities of the cerebral basal arteries by transcranial doppler and compared them with brain CT scan findings. We found that 12 patients (60%) with global or sensomotoric aphasia, 4 patients (20%) with motor or Broca's aphasia and 4 (20%) with sensoric or Wernicke aphasia had changes in mean blood flow velocities of a. cerebri media. We found that the greatest improvement of the comunication function generally occurs in the first 3 months after the onset. Frequency of aphasia was showen to decrease from 24% of the patients within the first 7 days after the onset to 12 % after 3 months. It depends on the age of patient at stroke onset, education level, handedness, postonset time stimulability and patients support network. However, the initial severity of the aphasia is one of the most relevant clinical predictors of the outcome of aphasia.

aphasia; stroke; transcranial doppler

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