Topographical evaluation of aphasia based on brain vascular territories

Topographical evaluation of aphasic brain lesions can enhance our knowledge of cognitive physiology and plasticity. This prospective study was conducted on 100 stroke-afflicted patients with aphasia admitted in Valie-Asr Hospital (Khorasan, Iran) in 2003. Topography of infarct lesions was detected by a neurologist based on the map of brain vascular territories in CT-scan. Aphasic lesions categorized in anterior cerebral artery (ACA), posterior cerebral artery (PCA), middle cerebral artery (MCA), total MCA, anterior cortical MCA, Posterior Cortical MCA and deep MCA territories. The ethics committee of the university approved this research project. The results showed that of a total of 52 patients, global aphasia in MCA, ACA, PCA and MCA+ACA territories existed in 88%, 4%, 4%, and 4% respectively. All of the 40 patients with Broca aphasia had infarct in MCA territory and in 75% of the patient’s anterior cortical MCA territory was involved. Furthermore, out of 6 patients evaluated, Wernicke aphasia with involvement of posterior cortical MCA and PCA territories existed in 66% and 16% of the patients respectively. Atypical topography of the lesions was found in 11% out of global and 27% out of Wernicke aphasias.