Skip to main content
SpringerLink
Log in

Acute aphasia after right hemisphere stroke

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Right hemispheric stroke aphasia (RHSA) rarely occurs in right- or left-handed patients with their language representation in right hemisphere (RH). For right-handers, the term crossed aphasia is used. Single cases, multiple cases reports, and reviews suggest more variable anatomo-clinical correlations. We included retrospectively from our stroke data bank 16 patients (right- and left-handed, and ambidextrous) with aphasia after a single first-ever ischemic RH stroke. A control group was composed of 25 successive patients with left hemispheric stroke and aphasia (LHSA). For each patient, we analyzed four modalities of language (spontaneous fluency, naming, repetition, and comprehension) and recorded eventual impairment: (1) on admission (hyperacute) and (2) between day 3 and 14 (acute). Lesion volume and location as measured on computed tomography (CT) and magnetic resonance imaging (MRI) were transformed into Talairach stereotaxic space. Nonparametric statistics were used to compare impaired/nonimpaired patients. Comprehension and repetition were less frequently impaired after RHSA (respectively, 56% and 50%) than after LHSA (respectively, 84% and 80%, P = 0.05 and 0.04) only at hyperacute phase. Among RHSA, fewer left-handers/ambidextrous than right-handers had comprehension disorders at second evaluation (P = 0.013). Mean infarct size was similar in RHSA and LHSA with less posterior RHSA lesions (caudal to the posterior commissure). Comprehension and repetition impairments were more often associated with anterior lesions in RHSA (Fisher’s exact test, P < 0.05). Despite the small size of the cohort, our findings suggest increased atypical anatomo-functional correlations of RH language representation, particularly in non-right-handed patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Alexander MP, Annett M (1996) Crossed aphasia and related anomalies of cerebral organization: case reports and a genetic hypothesis. Brain Lang 55(2):213–239

    Article  PubMed  CAS  Google Scholar 

  2. Alexander MP, Fischette MR, Fischer RS (1989) Crossed aphasias can be mirror image or anomalous. Case reports, review and hypothesis. Brain 112:953–973

    Article  PubMed  Google Scholar 

  3. Basso A, Lecours AR, Moraschini S, Vanier M (1985) Anatomoclinical correlations of the aphasias as defined through computerized tomography: exception. Brain Lang 26:201–229

    Article  PubMed  CAS  Google Scholar 

  4. Bütefisch CM, Kleiser R, Seitz RJ (2006) Post-lesional cerebral reorganisation: evidence from functional neuroimaging and transcranial magnetic stimulation. J Physiol Paris 99(4–6):437–454

    Article  PubMed  Google Scholar 

  5. Carr MS, Jacobson T, Boller F (1981) Crossed aphasia: analysis of four cases. Brain Lang 14:190–202

    Article  PubMed  CAS  Google Scholar 

  6. Croquelois A, Wintermark M, Reichhart M, Meuli R, Bogousslavsky J (2003) Aphasia in hyperacute stroke: language follows brain penumbra dynamics. Ann Neurol 54:321–329

    Article  PubMed  Google Scholar 

  7. Godefroy O, Dubois C, Debachy B, Leclerc M, Kreisler A (2002) Lille stroke program.Vascular aphasias: main characteristics of patients hospitalized in acute stroke units. Stroke 33:702–705

    Article  PubMed  CAS  Google Scholar 

  8. Habib M, Joanette Y, Ali-Cherif A, Poncet M (1983) Crossed aphasia in dextrals: a case report with special reference to site of lesion. Neuropsychologia 21(4):413–418

    Article  PubMed  CAS  Google Scholar 

  9. Hecaen H, Ajuriaguerra J (1963) Les gauchers. Prévalence manuelle et dominance cérébrale. Presses Universitaires de France, Paris

    Google Scholar 

  10. Hécaen H, Mazars G, Ramier AM, Goldblum MC, Mérienne L (1971) L’aphasie croisée chez un sujet bilingue (vietnamien–français). Rev Neurol 124:319–323

    PubMed  Google Scholar 

  11. Hillis AE, Newhart M, Heidler J, Barker PB, Herskovits EH, Degaonkar M (2005) Anatomy of spatial attention: insights from perfusion imaging and hemispatial neglect in acute stroke. J Neurosci 23:3161–3167

    Article  Google Scholar 

  12. Joanette Y (1989) Aphasia in left-handers and crossed aphasia. In: Boller F, Grafman J (eds) Handbook of neuropsychology, vol 2. Elsevier, Amsterdam, pp 173–183

    Google Scholar 

  13. Joanette Y, Puel M, Nespoulous JL, Rascol A, Lecours AR (1982) Aphasie croisée chez les droitiers. Rev Neurol 138:575–586

    PubMed  CAS  Google Scholar 

  14. Jörgens S, Kleiser R, Indefrey P, Seitz RJ (2007) Handedness and functional MRI-activation patterns in sentence processing. Neuroreport 18(13):1339–1343

    Article  PubMed  Google Scholar 

  15. Kenin M, Swisher LP (1972) A study of pattern of recovery in aphasia. Cortex 8(1):56–68

    PubMed  CAS  Google Scholar 

  16. Khedr EM, Hamed E, Said A, Basahi J (2002) Handedness and language cerebral lateralization. Eur J Appl Physiol 87:469–473

    Article  PubMed  Google Scholar 

  17. Knecht S, Drager B, Deppe M, Bobe L, Lohmann H, Flöel A, Ringelstein EB, Henningsen H (2000) Handedness and hemispheric language dominance in healthy humans. Brain 123:2512–2518

    Article  PubMed  Google Scholar 

  18. Kreisler A, Godefroy O, Delmaire C, Debachy B, Leclercq M, Pruvo JP, Leys D (2000) The anatomy of aphasia revisited. Neurology 54(5):1117–1123

    PubMed  CAS  Google Scholar 

  19. Marien P, Engelborghs S, Vignolo LA, De Deyn PP (2001) The many faces of crossed aphasia in dextrals: report of nine cases and review of the literature. Eur J Neurol 8:643–658

    Article  PubMed  CAS  Google Scholar 

  20. Marien P, Paghera B, De Deyn PP, Vignolo LA (2004) Adult crossed aphasia in dextrals revisited. Cortex 40:41–74

    Article  PubMed  Google Scholar 

  21. Mazaux JM, Orgogozo JM (1982) Echelle d’évaluation de l’aphasie adaptée du Boston diagnostic aphasia examination. EAP Editions Psychotechniques, Paris

    Google Scholar 

  22. Mazzocchi F, Vignolo LA (1979) Localisation of lesions in aphasia: clinical-CT scan correlations in stroke patients. Cortex 15:627–654

    PubMed  CAS  Google Scholar 

  23. Nespoulous JL, Lecours AR, Lafond D, Joanette Y, Lemay A, Puel M, Cot F, Rascol A (1992) Protocole Montréal-Toulouse d’examen linguistique de l’aphasie, MT 86, Module standard initial. Ortho Editions, Montréal

    Google Scholar 

  24. Oldfiedl RC (1971) The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9:97–113

    Article  Google Scholar 

  25. Pedersen PM, Vinter K, Olsen TS (2004) Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovasc Dis 17:35–43

    Article  PubMed  Google Scholar 

  26. Stone SP, Wilson B, Wroot A, Halligan PW, Lange LS, Marshall JC, Greenwood RJ (1991) The assessment of visuo-spatial neglect after acute stroke. J Neurol Neurosurg Psychiatry 54:345–350

    Article  PubMed  CAS  Google Scholar 

  27. Talairach J, Tournoux P (1988) Co-planar stereotaxic atlas of the human brain. Thieme, New York

    Google Scholar 

  28. Vignolo LA (1964) Evolution of aphasia and language rehabilitation: a retrospective exploratory study. Cortex 1:344–361

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Rue du Bugnon, 46, 1011, Lausanne, Switzerland

    Géraldine Maillard Dewarrat, Jean-Marie Annoni & Antonio Carota

  2. Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland

    Eleonora Fornari & Philippe Maeder

  3. Genolier Swiss Medical Network, Clinique Valmont-Genolier, Glion-sur-Montreux, Switzerland

    Julien Bogousslavsky

Authors
  1. Géraldine Maillard Dewarrat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean-Marie Annoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eleonora Fornari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Antonio Carota
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Julien Bogousslavsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Philippe Maeder
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Géraldine Maillard Dewarrat.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dewarrat, G.M., Annoni, JM., Fornari, E. et al. Acute aphasia after right hemisphere stroke. J Neurol 256, 1461–1467 (2009). https://doi.org/10.1007/s00415-009-5137-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-009-5137-z

Keywords

Search

Navigation