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Brain, Vol. 109, No. 1, 55-80, 1986
© 1986 Oxford University Press

research-article

BRAIN LESIONS ASSOCIATED WITH NONFLUENT APHASIA FIFTEEN YEARS FOLLOWING PENETRATING HEAD INJURY

CHRISTY L. LUDLOW1,2,, JEANNETTE ROSENBERG2, CHRISTINE FAIR2, DAVID BUCK3,2, SARAH SCHESSELMAN4,2 and ANDRES SALAZAR2

1Speech Pathology Unit, Human Motor Control Section, Medical Neurlogy Branch, National Institute of Neurological and Communicative Disorders and Stroke Bethesda, MD 20892 2Vietnam Head Injury Study, Walter Reed Army Medical Center Washington, DC 20307 3Department of Radiology, Washington Hospital Center Washington DC 20010 4Biostatistics Center George Washington University Bethesda, MD 20814, USA

Correspondence to: Correspondence to: Dr Christy L Ludlow, Speech Pathology Unit, Human Motor Control Section, MNB, IRP, National Institute of Neurological and Communicative Disorders and Stroke, Building 10, Room 5N226, Bethesda, MD 20892 USA

Men who sustained penetrating head injuries resulting in nonfluent aphasia within six months following injury, were examined fifteen years later and classified into two groups, 13 with persistent nonfluent aphasia, and 26 without symptoms of aphasia. Relative to a normal control group on a comprehensive battery of speech and language tests, the chronic nonfluent aphasies demonstrated syntactic processing deficits in all language modalities, with only mild or no impairment in other language faculties. The recovered group demonstrated deficits only in written expressive syntax.

The CT lesions of the two groups differed in the extent of left hemisphere lesion volume and the degree of posterior and deep lesion extension within the left hemisphere. The nonrecovered group did not have greater right hemisphere damage. Broca's area was equally involved in 77 per cent of patients in both groups All patients in the nonrecovered group had posterior extension of their lesions in Wernicke's area with some involvement of the underlying white matter and basal ganglia in the left hemisph

Received September 11, 1984. Revised . Accepted November 5, 1985.


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