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失语通常被认为是左半球损害所致,但随着 CT的应用,皮层下损害所造成的失语症也常有报导,从而使“言语解剖”的概念发生变化。本研究的目的是要验证:皮层下失语症可能是由于深层损害之上的皮层言语区(CT 表现正常)的循环障碍所致。方法:对25名经 CT 核实为左半球损害的急性卒中病人,在卒中后1—4天内行脑血管造影及测定局部脑血流(rCBF)。全部病人在急性期和6个月后都分别做失语学及 CT 检查。两次 CT 扫描其梗塞的大小是相同的。结果:一、7名患者有皮层损害:这组病人在急性期入院时都有严重失语,其恢复都很差。6个月后仅稍有改善,此时仍有中到重度失语(持久性失语)。相应于 CT 扫描之梗塞,局部脑血流有严重下
Aphasia is usually thought to be caused by damage to the left hemisphere, but as the application of CT, aphasia caused by subcortical damage is also often reported, thus changing the concept of “speech anatomy.” The purpose of this study was to validate that subcortical aphasia may be due to a circulatory disturbance of the cortical speech zone (normal CT appearance) above deep lesions. METHODS: Twenty-five acute stroke patients with CT-confirmed lesions in the left hemisphere underwent cerebral angiography and local cerebral blood flow (rCBF) within 1-4 days of stroke. All patients in the acute phase and after 6 months were done aphasia and CT examination. The size of the infarct is the same for both CT scans. Results: First, seven patients had cortical damage: All patients in this group had severe aphasia at admission and were poorly recovered. After 6 months only a slight improvement, there are still moderate to severe aphasia (persistent aphasia). Corresponds to the CT scan infarction, local cerebral blood flow is serious