Transient Broca's aphasia as feature of an extradural abscess.
Diagnosis of extradural abscesses can be difficult and is often delayed. The case is presented of a 13-year-old girl who was afebrile and had episodes of expressive aphasia, with maintenance of awareness and understanding, lasting for 2-3 minutes and with normal neurologic examination in between. She was found to have a left frontal extradural abscess overlying the region of Broca's area (Brodmann area 44/45) on magnetic resonance imaging. An electroencephalogram showed continuous delta activity in the left frontotemporal region. She made a full recovery after surgical evacuation of pus, which upon culture grew Streptococcus milleri. The possible cause of transient aphasia in this condition is pressure-induced or inflammatory mediator-induced ischemia, with or without associated focal seizures.
Commondoor
Raghuram
R
Luton and Dunstable Hospital, NHS Foundation Trust, Luton, United Kingdom.
Eisenhut
Michael
M
Fowler
Charlotte
C
Kirollos
Ramirez W
RW
Nathwani
Nisha
N
D000293:Adolescent; D001039:Aphasia, Broca / Q000209:etiology* / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D004569:Electroencephalography; D020802:Epidural Abscess / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D020127:Recovery of Function; D034364:Streptococcus milleri Group / Q000302:isolation & purification; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology*