title: [Transcortical sensory aphasia due to extensive infarction of left cerebral hemisphere].
abstract: We report a case of transcortical sensory aphasia occurred after extensive infarction of left cerebral hemisphere. A 68-year-old, right-handed man with atrial fibrillation suddenly developed cerebral embolism of left middle cerebral artery. He was treated conservatively, and the right hemiplegia, aphasia, apraxia in a slight degree and right hemispatial neglect in a slight degree consequently existed. MRI showed a large cortical and subcortical infarct lesion including the left Broca's area, central region, perisylvian area with Wernicke's area and temporal lobe. In contrast, neuropsychological evaluation using the Western Aphasia Battery (WAB) demonstrated transcortical sensory aphasia, e.g., fluency 8, auditory comprehension 1. repetition 10 and object naming 2.4. In addition to preserved repetition, both linguistic prosody and affective prosody were well preserved. Most cases with transcortical sensory aphasia are known to occur with the lesion including temporo-parieto-occipital junction of dominant hemisphere. Our patient and a few other reported cases of transcortical sensory aphasia had a lesion in perisylvian area including Wernicke's area. Therefore, it is possible that their minor hemisphere worked selectively for repetition. Furthermore, we suggest that this patient presented dissociative aphasia that all the process of repetition and the function of linguistic and emotional prosody were represented in the right hemisphere and the other functions including comprehension of word meanings were existed in the left hemisphere. We believe that our case of transcortical sensory aphasia with dissociative aphasia gives a suggestion about the mechanism and localization of repetition and prosody in the whole system of language.
authors.affiliation: Department of Neurology, Tokyo Metropolitan Neurological Hospital.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Warabi
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Bandoh
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurisaki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nishio
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D001041:Aphasia, Wernicke / Q000209:etiology* / Q000503:physiopathology; D004292:Dominance, Cerebral; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D010296:Parietal Lobe / Q000473:pathology; D013702:Temporal Lobe / Q000473:pathology