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February 1980, Vol 37, No. 2 >
Article | February 1980

The Aphasia Syndrome of Stroke in the Left Anterior Cerebral Artery Territory

Michael P. Alexander, MD; Mary Anne Schmitt, MA, CCC
[+] Author Affiliations

Accepted for publication Feb 16, 1979.

Reprint requests to Neurobehavioral Unit, Boston Veterans Administration Medical Center, 150 S Huntington Ave, Boston, MA 02130 (Dr Alexander).


Arch Neurol. 1980;37(2):97-100. doi:10.1001/archneur.1980.00500510055010
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Comments

• Two patients with transcortical motor aphasia are described. Both had infarcts in the distribution of the left anterior cerebral artery confirmed by computerized tomography (CT). The distinctive language abnormality, unusual EEG pattern, and nuclide and CT scan abnormalities all allow ready diagnosis of the syndrome of infarction in this distribution. The mechanism of the language disturbance is reviewed and implications for treatment and prognosis are discussed.

REFERENCES

1 +
Mohr JP:  Broca's area and Broca's aphasia . Neurology 28:311-324, 1978;.
2 +
Hayward RW, Naeser MA, Zatz LM:  Cranial computed tomography in aphasia . Radiology 123:653-660, 1977;.
3 +
Benson DF, Geschwind N:  The aphasias and related disturbances , in Baker AB, Baker LH (eds): Clinical Neurology . Hagerstown, Md, Harper & Row, 1976;, chap 8, p 11.
4 +
Rubens AB:  Transcortical motor aphasia , in Whitaker H, Whitaker H (eds): Studies in Neurolinguistics . New York, Academic Press Inc, 1976;, vol 1, pp 293-303.
5 +
Rubens AB:  Aphasia with infarction in the territory of the anterior cerebral artery . Cortex 11:239-250, 1975;.
6 +
Atkinson MS:  Transcortical motor aphasia associated with left frontal lobe infarction . Trans Am Neurol Assoc 96:136-140, 1971;.
7 +
Damasio AR, Kassel NF:  Transcortical motor aphasia in relation to lesions of the supplementary motor area . Neurology 28:396, 1978;.
8 +
Goodglass H, Kaplan E: The Assessment of Aphasia and Related Disorders . Philadelphia, Lea & Febiger, 1972;, p 73.
9 +
Critchley M:  The anterior cerebral artery and its syndromes . Brain 53:120-165, 1930;.
10 +
Adams RD, Victor M: Principles of Neurology . New York, McGraw-Hill, 1977;, p 506.
11 +
Elsberg CA:  The parasagital meningeal fibroblastomas . Bull Neurol Inst NY 1:389-418, 1931;.
12 +
Penfield W, Welch K:  The supplementary motor area of the cerebral cortex . Arch Neurol Psychiatr 66:289-317, 1951;.
13 +
Erickson TC, Wodsey CN:  Observations on the supplementary motor area of man . Trans Am Neurol Assoc 76:50-56, 1951;.
14 +
Arseni C, Botez MI:  Speech disturbances caused by tumors of the supplementary motor area . Acta Psychiatr Neurol Scand 36:279-299, 1961;.
15 +
Guidetti B:  Désordres de la parole associés de la surface interhemisphérique . Rev Neurol 97:123-131, 1957;.
16 +
Alajouanine T, Castaigne P, Sabouraud O, et al:  Palilalie paroxystique et vocalisations itératives au cours de crises épileptiques par lésion intéressant l'aire motrice supplémentaire . Rev Neurol 685-697, 1959;.
17 +
Botez MI:  Clinical contributions to the study of the tumoral frontal syndrome . Psychiatr Neurol 140:351-368, 1960;.
18 +
Petit-Dutaillis D, Guiot G, Messing R, et al:  Apropos d'une aphémie par atteinte de la zone matrice supplémentaire de Penfield . Rev Neurol 90:95-106, 1954;.
19 +
Poppen VL:  Ligation of the left anterior cerebral artery . Arch Neurol Psychiatr 41:495-503, 1939;.
20 +
Von Stockert TR:  Aphasia sine aphasia . Brain Language 1:277-282, 1974;.
21 +
Kertesz A, Lesk D, McCabe P:  Isotope localization of infarcts in aphasia . Arch Neurol 34:590-601, 1977;.
22 +
Geschwind N, Kaplan E:  A human cerebral deconnection syndrome . Arch Neurol 12:675-85, 1962;.
23 +
Kiloh LG, McComas AJ, Osselton JW: Clinical Electroencephalography . London, Butter-worth & Co, 1972;, pp 130-137.
24 +
Lichtheim L:  On aphasia . Brain 7:433-484, 1885;.
25 +
Bastian HC:  Some problems in connection with aphasia and other speech defects . Lancet 1:1005-1017, 1132-1137, 1187-1194, 1897;.
26 +
Goldstein K: Language and Language Disorders . New York, Grune & Stratton, 1948;, pp 292-324.
27 +
Milner B:  Some effects of frontal lobectomy in man , In Warner JM, Ackert K (eds): The Frontal Granular Cortex and Behavior . New York, McGraw-Hill, 1964;, pp 313-331.
28 +
Botez MI, Barbeau A:  Role of subcortical structures and particularly the thalamus in the mechanisms of speech and language . Int J Neurol 8:300-320, 1971;.
29 +
Luria AR, Tsvetisova LS:  Towards the mechanisms of dynamic aphasia . Acta Neurol Psychiatr Belg 67:1045-57, 1967;.
30 +
Sparks R, Helm N, Albert M:  Aphasia rehabilitation resulting from melodic intonation therapy . Cortex 10:303-16, 1974;.
31 +
Helm N:  What is the theoretical rationale for using melodic intonation therapy? Tex J Audiol Speech Pathol 3:11, 1978;.
32 +
Kertesz A, McCabe P:  Recovery patterns and prognosis in stroke . Brain 100:1-18, 1977;.

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1 +
Mohr JP:  Broca's area and Broca's aphasia . Neurology 28:311-324, 1978;.
2 +
Hayward RW, Naeser MA, Zatz LM:  Cranial computed tomography in aphasia . Radiology 123:653-660, 1977;.
3 +
Benson DF, Geschwind N:  The aphasias and related disturbances , in Baker AB, Baker LH (eds): Clinical Neurology . Hagerstown, Md, Harper & Row, 1976;, chap 8, p 11.
4 +
Rubens AB:  Transcortical motor aphasia , in Whitaker H, Whitaker H (eds): Studies in Neurolinguistics . New York, Academic Press Inc, 1976;, vol 1, pp 293-303.
5 +
Rubens AB:  Aphasia with infarction in the territory of the anterior cerebral artery . Cortex 11:239-250, 1975;.
6 +
Atkinson MS:  Transcortical motor aphasia associated with left frontal lobe infarction . Trans Am Neurol Assoc 96:136-140, 1971;.
7 +
Damasio AR, Kassel NF:  Transcortical motor aphasia in relation to lesions of the supplementary motor area . Neurology 28:396, 1978;.
8 +
Goodglass H, Kaplan E: The Assessment of Aphasia and Related Disorders . Philadelphia, Lea & Febiger, 1972;, p 73.
9 +
Critchley M:  The anterior cerebral artery and its syndromes . Brain 53:120-165, 1930;.
10 +
Adams RD, Victor M: Principles of Neurology . New York, McGraw-Hill, 1977;, p 506.
11 +
Elsberg CA:  The parasagital meningeal fibroblastomas . Bull Neurol Inst NY 1:389-418, 1931;.
12 +
Penfield W, Welch K:  The supplementary motor area of the cerebral cortex . Arch Neurol Psychiatr 66:289-317, 1951;.
13 +
Erickson TC, Wodsey CN:  Observations on the supplementary motor area of man . Trans Am Neurol Assoc 76:50-56, 1951;.
14 +
Arseni C, Botez MI:  Speech disturbances caused by tumors of the supplementary motor area . Acta Psychiatr Neurol Scand 36:279-299, 1961;.
15 +
Guidetti B:  Désordres de la parole associés de la surface interhemisphérique . Rev Neurol 97:123-131, 1957;.
16 +
Alajouanine T, Castaigne P, Sabouraud O, et al:  Palilalie paroxystique et vocalisations itératives au cours de crises épileptiques par lésion intéressant l'aire motrice supplémentaire . Rev Neurol 685-697, 1959;.
17 +
Botez MI:  Clinical contributions to the study of the tumoral frontal syndrome . Psychiatr Neurol 140:351-368, 1960;.
18 +
Petit-Dutaillis D, Guiot G, Messing R, et al:  Apropos d'une aphémie par atteinte de la zone matrice supplémentaire de Penfield . Rev Neurol 90:95-106, 1954;.
19 +
Poppen VL:  Ligation of the left anterior cerebral artery . Arch Neurol Psychiatr 41:495-503, 1939;.
20 +
Von Stockert TR:  Aphasia sine aphasia . Brain Language 1:277-282, 1974;.
21 +
Kertesz A, Lesk D, McCabe P:  Isotope localization of infarcts in aphasia . Arch Neurol 34:590-601, 1977;.
22 +
Geschwind N, Kaplan E:  A human cerebral deconnection syndrome . Arch Neurol 12:675-85, 1962;.
23 +
Kiloh LG, McComas AJ, Osselton JW: Clinical Electroencephalography . London, Butter-worth & Co, 1972;, pp 130-137.
24 +
Lichtheim L:  On aphasia . Brain 7:433-484, 1885;.
25 +
Bastian HC:  Some problems in connection with aphasia and other speech defects . Lancet 1:1005-1017, 1132-1137, 1187-1194, 1897;.
26 +
Goldstein K: Language and Language Disorders . New York, Grune & Stratton, 1948;, pp 292-324.
27 +
Milner B:  Some effects of frontal lobectomy in man , In Warner JM, Ackert K (eds): The Frontal Granular Cortex and Behavior . New York, McGraw-Hill, 1964;, pp 313-331.
28 +
Botez MI, Barbeau A:  Role of subcortical structures and particularly the thalamus in the mechanisms of speech and language . Int J Neurol 8:300-320, 1971;.
29 +
Luria AR, Tsvetisova LS:  Towards the mechanisms of dynamic aphasia . Acta Neurol Psychiatr Belg 67:1045-57, 1967;.
30 +
Sparks R, Helm N, Albert M:  Aphasia rehabilitation resulting from melodic intonation therapy . Cortex 10:303-16, 1974;.
31 +
Helm N:  What is the theoretical rationale for using melodic intonation therapy? Tex J Audiol Speech Pathol 3:11, 1978;.
32 +
Kertesz A, McCabe P:  Recovery patterns and prognosis in stroke . Brain 100:1-18, 1977;.

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