We describe a left-handed patient with transient aphasia and bilateral carotid stenosis. Computed tomography (CT) arteriography showed a 90% stenosis of the right and 30% stenosis of the left internal carotid artery. Head CT and magnetic resonance imaging (MRI) of the brain showed no recent ischemic changes. As only the symptomatic side would require surgical intervention, and because hemispheric dominance for language in left-handed patients may be either left or right sided, a preoperative assessment of hemispheric dominance was required. We used functional MRI to determine hemispheric dominance for language and hence to establish the indication for carotid endarterectomy surgery. Functional MRI demonstrated right hemispheric dominance for language and right-sided carotid endarterectomy ...MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Abstract  Stroke rehabilitation is evolving into a clinical field based on the neuroscience of recovery and restoration. There has been substantial growth in the number and quality of clinical trials performed. Much effort now is directed toward motor restoration and is being led by trials of constraint-induced movement therapy. Although the results do not necessarily support that constraint-induced movement therapy is superior to other training methods, this treatment has become an important vehicle for developing clinical trial methods and studying the physiology underlying activity-based rehabilitation strategies. Other promising interventions include robotic therapy delivery, magnetic and electrical cortical stimulation, visualization, and constraint-driven aphasia ther...

We examined the outcome of a 1-month intensive treatment block for people with chronic aphasia. The selected participants were eight chronically impaired people (mean months post-onset [MPO], 34). We conducted pre- and post-treatment assessments using the English-language version of the Aachen Aphasia Test (EAAT) and the Communicative Effectiveness Index (CETI). The group had significant overall improvement following treatment, which was maintained for 1 month, most significant changes seen on the EAAT were mainly in naming, comprehension, and reading and writing. Improvement was also observed on the CETI. Individual responses to treatment were variable, with some participants making more progress than others. Although the more mildly aphasic participant made most gains overall, the most s...

Semin Speech Lang 2010; 31: 034-041DOI: 10.1055/s-0029-1244951ABSTRACTComputers and related technology can increase the amount of treatment received by adults with chronic aphasia. Computers used in treatment, however, are only valuable to the patient if the intervention is efficacious. Real and potential applications of computer technology are discussed in the context of three roles of computerized aphasia treatment for adults with chronic aphasia. Pertinent studies regarding Phases 1 and 2 are briefly described. The only Phase 3 study of efficacy of computerized aphasia treatment is more fully described and its implications discussed.[...]Published by Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Speech and Language)

Semin Speech Lang 2010; 31: 052-063DOI: 10.1055/s-0029-1244953ABSTRACTThis event-related functional magnetic resonance imaging (fMRI) study reports on the impact of semantic feature analysis (SFA) therapy on the neural substrate sustaining the recovery from severe anomia in two patients: one participant was diagnosed with primary progressive aphasia (PPA) 2 years before this study; the other participant acquired aphasia 8 years before this study. The participant with PPA showed severe progressive nonfluent aphasia (PNFA), the language profile being similar to a Broca's aphasia; the stroke patient presented with Broca's aphasia and a severe apraxia of speech (AOS).[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Speech ...

Semin Speech Lang 2010; 31: 003-004DOI: 10.1055/s-0029-1244948© Thieme Medical PublishersGet connected:Table of contents  |  FREE: Full text (Source: Seminars in Speech and Language)MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Authors: Rosca EC The present paper describes a case of a patient with severe Wernicke aphasia, which when tested with a number processing and calculation battery adapted to his difficulties showed remarkable arithmetic skills. These findings suggest that the patients with severe cognitive impairments (e.g., aphasia, apraxia) should be tested with batteries adapted to their disturbances because using a standard test may bias the results. PMID: 20221669 [PubMed - as supplied by publisher] (Source: Cognitive Processing)

Aphasia — Comprehensive overview covers causes, treatment, coping skills for this communication disorder. (Source: MayoClinic.com Full Feed)

In conclusion, valproate can induce delirium at therapeutic blood levels in some patients via various mechanisms and this side effect has to be considered during valproate use. PMID: 20204907 [PubMed - in process] (Source: Turkish Journal of Psychiatry)

This article provides a clinically oriented review of PPA. Different clinical presentations and imaging findings of 3 subtypes, agrammatic, semantic and logopenic, are presented. Underlying neuropathology, medical and social management aspects of these patients are reviewed. (Source: American Journal of Alzheimer's Disease and Other Dementias)

Authors: Baldo JV, Bunge SA, Wilson SM, Dronkers NF Previous studies with brain-injured patients have suggested that language abilities are necessary for complex problem-solving, even when tasks are non-verbal. In the current study, we tested this notion by analyzing behavioral and neuroimaging data from a large group of left-hemisphere stroke patients (n=107) suffering from a range of language impairment from none to severe. Patients were tested on the Raven's Colored Progressive Matrices (RCPM), a non-verbal test of reasoning that requires participants to complete a visual pattern or sequence with one of six possible choices. For some items, the solution could be determined by visual pattern-matching, but other items required more complex, relational reasoning. As predicted, performa...MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Conclusions: The CIQ adjusted for people with aphasia seems to be an adequate instrument to assess participation in people with aphasia. (Source: Archives of Physical Medicine and Rehabilitation)

We report a very rare case of an overdose intrathecal GD injection presenting with neurotoxic manifestations, including a decreased level of consciousness, global aphasia, rigidity, and visual disturbance. PMID: 20191058 [PubMed - in process] (Source: J Korean Med Sci)

Alzheimer's disease is the most prevalent and common form of cognitive impairment, ie, dementia, in the elderly followed in second place by vascular dementia due to the microangiopathy associated with poorly-controlled hypertension. Besides blood pressure elevation, advancing age is the strongest risk factor for dementia. Deterioration of intellectual function and cognitive skills that leads to the elderly patient becoming more and more dependent in his, her, activities of daily living, ie, bathing, dressing, feeding self, locomotion, and personal hygiene. It has been known and demonstrated for many years that lowering of blood pressure from a previous hypertensive point can result in stroke prevention yet lowering of blood pressure does not prevent the microangiopathy that leads to white ...

Cranial pachymeningitis is a poorly understood syndrome, defined by leptomeningeal thickening and typical gadolinium enhanced MRI. The heterogeneous clinical and aetiological features of five patients with both focal and diffuse pachymeningitis are presented. The initial symptoms included headache (n=3), sensory Jackson seizures (n=1), hemiparesis (n=1), episodes of short lasting hemiataxia (n=1), hemihypaesthesia (n=1), aphasia (n=1) and confusion (n=2). MRI scans revealed focal (n=3) or diffuse (n=2) leptomeningeal gadolinium enhancement and cortical swelling (n=4). In addition, one case presented with a subarachnoid and a second with an intracerebral haemorraghe. CSF findings were variable and showed clear lymphomonocytic pleocytosis in 3/5 cases. Infectious diseases were extensively ex...

Temporal-lobe lesions sometimes cause apnoeic attacks in infants, but they rarely cause apnoeic attacks in adults. An 80-year-old woman with a history of hypertension was admitted to hospital because of global aphasia and mild right hemiparesis. The admission head CT showed small subcortical haemorrhage in the left temporal lobe. Immediately after the CT, her respiratory rate decreased to 3/min, and her arterial blood gas analysis showed respiratory acidaemia without any evidence of airway obstruction or additional neurological deficits. Thus, she required artificial ventilation. Single-photon emission CT performed on the same day showed hyperperfusion in the left temporal region, but the electroencephalogram showed no epileptic spike. When mechanical ventilation was discontinued on the fo...MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Cortex was founded in 1964 by Ennio De Renzi. As such it is one of the oldest journals of Neuropsychology, launched at the turning point in the history of the field (see ). According to the blurb presenting it, “Cortex is an international journal devoted to the study of cognition and of the relationship between the nervous system and mental processes, particularly as these are reflected in the behaviour of patients with acquired brain lesions, normal volunteers, children with typical and atypical development, and in the activation of brain regions and systems as recorded by functional neuroimaging techniques”. That is, Neuropsychology, as the composition of the term implies, is typically an interdisciplinary endeavour, which serves as a bridge between different levels of analysis and f...

CONCLUSIONS: Patients fulfilling definition A and F had best short-term and medium-term outcomes. They would be best suited to the definition of "minor stroke." PMID: 20185781 [PubMed - as supplied by publisher] (Source: Stroke)

We describe clinico-pathological findings in a patient with progressive anterior operculum syndrome. A 74-year-old right-handed man had noticed speech and swallowing difficulties 1 year previously. Neurological examinations showed no abnormality other than a slight limitation of upward gaze and slow tongue movement without fibrillation. We investigated the patient using neuroimaging and neuropsychological examinations and observed him for 2 years until his death, at which point we obtained pathological findings. The patient’s facial and masseteric muscles seemed hypotonic with drooling, but he could laugh and yawn normally, showing automatic voluntary dissociation. Palatal and pharyngeal reflexes were normal. Magnetic resonance imaging showed cortical atrophy in the tempo...

Conclusions: Semi-automated MRI atrophy measures are potentially useful objective biomarkers of progression in frontotemporal lobar degeneration (FTLD); however, careful stratification of FTLD subtypes will be important in future clinical trials of disease-modifying therapies. (Source: Neurology)