Contrecoup injury in the misdiagnosis of crossed aphasia.
Crossed aphasia is reported to be more frequent in traumatic series than in series of patients with other pathologies. A right-handed young man suffered a closed-head trauma and became aphasic and hemiparetic on the left. CT scan revealed a right frontal-lobe hematoma. Neuropsychological examination revealed a fluent aphasia and a Gerstmann syndrome. These signs were compatible with left supramarginal gyrus syndrome. However, the presence of a right frontal-lobe lesion suggested that this patient could be a crossed aphasic. Subsequent EEG study showed a left occipitotemporal focus and a right frontal one. Aphasic signs could thus be due to the left lesion, which was the result of a contrecoup mechanism. Fluent aphasias have been reported in closed-head trauma with right frontal impact. Attention is called for the possible bias of including cases like this in series of traumatic crossed aphasia.
D000328:Adult; D001037:Aphasia / Q000145:classification / Q000175:diagnosis* / Q000209:etiology; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D006259:Craniocerebral Trauma / Q000150:complications; D003951:Diagnostic Errors; D004569:Electroencephalography; D006406:Hematoma / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D014057:Tomography, X-Ray Computed