title: Global aphasia as a predictor of mortality in the acute phase of a first stroke.
abstract: OBJECTIVE
  To establish whether vascular aphasic syndromes can predict stroke outcomes.
  
  
  METHODS
  Thirty-seven adults were evaluated for speech and language within 72 hours after a single first-ever ischemic brain lesion, in blind association to CT and/or MR.
  
  
  RESULTS
  Speech or language disabilities were found in seven (87.5%) of the eight deceased patients and twenty-six (89.7%) of the twenty-nine survivors. Global aphasia was identified in eleven patients, all with left hemisphere lesions (nine mute; five deceased), consisting on a risk factor for death in the acute stroke phase (ρ=0.022). Age (z=1.65; ρ>0.09), thrombolysis (ρ=0.591), infarct size (ρ=0.076) and side (ρ=0.649) did not significantly influence survival. Absence of aphasia did not predict a better evolution, regardless of the affected hemisphere. Prevalence of cardiovascular risk factors was similar for all patient groups.
  
  
  CONCLUSIONS
  Global aphasia in acute stroke can adversely affect prognosis, translated into impairment of dominant perisylvian vascular territories, with mutism as an important semiological element.
authors.affiliation: Department of Neurology, University of Campinas, Campinas, SP, Brazil. fabricioferreiradeoliveira@hotmail.com
authors.forename: Fabricio Ferreira de
authors.initials: FF
authors.lastname: Oliveira
authors.forename: Benito Pereira
authors.initials: BP
authors.lastname: Damasceno
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000175:diagnosis / Q000209:etiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000150:complications* / Q000401:mortality; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed