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Is Aphasia a Significant Prognostic Factor for the Recovery of Function After Ischemic Stroke Causing Hemiparesis?

Neurological Hospital, University of Erlangen-Nuremberg at Erlangen

T. Berendes

Neurological Hospital, University of Erlangen-Nuremberg at Erlangen

W. Sauerbrei

Institute for Medical Documentation and Statistics, University of Freiburg i.Br., Federal Republic of Germany

P. Bartelsen

Neurological Hospital, University of Erlangen-Nuremberg at Erlangen

B. Neundörfer

Neurological Hospital, University of Erlangen-Nuremberg at Erlangen

The prognostic significance of aphasia with motor deficits caused by ischemic stroke is still a matter of debate. To further clarify this issue, we personally reassessed 111 patients with cerebral infarction in either the left or right hemisphere (ascertained by computed tomography) after a mean follow-up of 53.8 months (±17.3 months). Aphasia, viewed on its own, was a strong predictor both of survival and of activities of daily living. Since a strong correlation between severity of aphasia and severity of motor deficits exists in left hemisphere strokes, both variables may be better differentiated when compared with right hemisphere infarcts. Nevertheless, in our sample aphasia was of no additional prognostic value to hemiparesis with regard to contact with other people, degree of incapacity, and self-care status. However, vocational status and several daily activities more or less overtly dependent on language skills (using a phone, reading the newspaper, writing letters, watching television, following a conversation) were in fact influenced by aphasia. Our results indicate that, in the presence of motor deficits, the severity of aphasia in the chronic stage may or may not additionally influence the long-term outcome following left or left and right hemispheric cerebral infarction, depending on the choice of the target variables.

Key Words: Ischemic stroke • Aphasia • Prognosis.

Neurorehabilitation and Neural Repair, Vol. 3, No. 4, 177-186 (1989)
DOI: 10.1177/136140968900300402


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