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Published on: December 6, 2016
Speech arrest after sleeping on the left body side.
Lars Wojtecki1, Alfons Schnitzler
1Department of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. wojtecki@uni-duesseldorf.de
British Journal of Neurosurgery
|April 20, 2011
Summary
Transient speech arrest after left hemicraniectomy may result from sleeping on the affected side. This suggests mechanical compression of the brain surface can cause stroke-like episodes.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Stroke-like episodes can arise from increased intracranial pressure causing cortical compression.
- Hemicraniectomy, a procedure involving skull bone removal, can leave the brain surface unprotected.
Observation:
- A patient who underwent a left hemicraniectomy experienced transient speech arrest after sleeping on their left side.
- This speech arrest resolved upon changing sleeping position.
Findings:
- The transient speech arrest is hypothesized to be caused by mechanical compression of the left inferior or superior frontal gyrus.
- This compression mimics the effects of a major mass effect on an unprotected brain surface.
Implications:
- Positional management may be crucial for patients with hemicraniectomy to prevent neurological deficits.
- This case highlights the vulnerability of the exposed brain after hemicraniectomy and the importance of considering mechanical factors in neurological symptoms.
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