Isolated Traumatic Expressive Aphasia

CASE REPORT A 59-year-old male presented to the emergency department after having been struck on the head multiple times with a hammer. On presentation, vital signs were all within normal limits and primary exam was only impressive for a large left sided parietal-temporal hematoma. The patient could move all extremities and follow all commands. It was noted, however, that he was not speaking. Initially his aphasia was thought to be volitional, but on further evaluation he appeared frustrated that he was not able to communicate. When provided pen and paper, he was unable to write. A computed tomography of the head was obtained and showed a left-sided depressed skull fracture, as well as underlying subdural bleeding. This patient was urgently taken to the Figure 1. Computed tomography of a left-sided depressed skull fracture and associated subdural hematoma over the temporal region of the cortex resulting in persistent expressive aphasia. Supervising Section Editor: Sean Henderson, MD Submission history: Submitted April 3, 2010; Revision Received July 23, 2010; Accepted September 27, 2010 Reprints available through open access at http://escholarship.org/uc/uciem_westjem [West J Emerg Med. 2011;12(1):141.]