To the Editor.
—We would like to comment on the study by Naeser et al on the relationship between lesion size on computed tomographic (CT) scan and recovery in Wernicke's aphasia.1 Although CT scanning can provide accurate information on anatomic damage in vascular stroke, cerebral perfusion imaging and cerebral metabolic imaging often show a much larger area of involvement.2,3 This new technology supports the notion that cerebral areas can be damaged and nonfunctional, although CT imaging remains normal due to the lack of significant cell death in surrounding areas.To illustrate this point, we would like to present a case of ischemic stroke with no anatomic abnormality by either CT or magnetic resonance imaging. Single photon emission computed tomography (SPECT) with iodine 123-N-isopropyliodoamphetamine IIMP) revealed large perfusion deficits that were reflected in the clinical neurologic findings.
Harsch HH, Tikofsky RS, Collier BD. Single Photon Emission Computed Tomography Imaging in Vascular Stroke. Arch Neurol. 1988;45(4):375–376. doi:10.1001/archneur.1988.00520280017010
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