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Transient aphasias after left hemisphere resective surgery.

Stephen M Wilson1,2, Daniel Lam3, Miranda C Babiak3

  • 1Departments of 1 Speech, Language, and Hearing Sciences and.

Journal of Neurosurgery
|June 27, 2015
PubMed
Summary

Transient aphasias are common after brain surgery. The study found that specific language deficits after left hemisphere surgery depend on the exact location of the resection site.

Keywords:
ADC = apparent diffusion coefficientAQ = Aphasia QuotientBNT = Boston Naming TestBTLA = basal temporal language areaDWI = diffusion-weighted imagingMNI = Montreal Neurological InstituteROI = region of interestVLSM = voxel-based lesion-symptom mappingWAB = Western Aphasia Batteryaphasiaresective surgeryvoxel-based lesion-symptom mapping

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Area of Science:

  • Neuroscience
  • Neurolinguistics
  • Neurosurgery

Background:

  • Transient aphasias frequently occur post-resection in the language-dominant hemisphere.
  • Understanding the relationship between surgical site and language deficits is crucial for patient outcomes.

Purpose of the Study:

  • To determine the incidence and nature of transient aphasias following language-dominant hemisphere surgery.
  • To investigate correlations between surgical site location and specific language domain impairments.

Main Methods:

  • Prospective study of 110 patients undergoing language-dominant hemisphere resection.
  • Language evaluation pre-surgery, 2-3 days post-surgery, and 1 month post-surgery using Western Aphasia Battery and Boston Naming Test.
  • Voxel-based lesion-symptom mapping to correlate MRI-assessed surgical site with language deficits.

Main Results:

  • 71% of patients exhibited aphasia 2-3 days post-surgery, affecting fluency, information content, comprehension, repetition, and naming.
  • Specific deficits linked to resection sites: fluency (precentral gyrus), information content (inferior frontal gyrus), repetition (superior temporal gyrus), and naming (temporal cortex).
  • Most aphasias resolved by 1 month, with naming being the only significantly affected domain compared to pre-surgery levels.

Conclusions:

  • Transient aphasias are highly prevalent after left hemisphere resective surgery.
  • The location of the surgical site dictates the specific type of aphasia observed.
  • This study offers insights into the neural basis of language due to discrete, localized resections.