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March 1987

Global Aphasia Without Hemiparesis

Author Affiliations

From the Departments of Neurology, Divisions of Behavioral Neurology (Drs Tranel and Damasio) and Cerebrovascular Diseases (Drs Biller and Adams), and Radiology, Section of Neuroradiology (Dr Cornell), University of Iowa, Iowa City.

Arch Neurol. 1987;44(3):304-308. doi:10.1001/archneur.1987.00520150050021

• Three patients acutely developed global aphasia, but did not manifest the typical accompanying right hemiparesis. Computed tomography and magnetic resonance imaging studies demonstrated that the patients had two discrete left hemisphere lesions, one in the anterior language cortices or language-related subcortical areas, and one in the posterior language cortices. Cerebral angiography showed that two patients had complete occlusion of the left internal carotid artery, and the third had an intraluminal "clot" in the supraclinoid portion of the left internal carotid, findings suggestive of an embolic etiology. Our cases indicate that global aphasia without hemiparesis predicts two discrete lesions and a particularly good recovery of speech and language.

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