[Localization of lesions in aphasia: clinical-CT scan correlations (Part II)]

On the basis of the characteristic symptoms or the result of a speech examination, 127 right-handed cases with various types of aphasia were subdivided into two groups within each aphasic syndrome. Using a microcomputer, the locus and extent of the lesions, as demonstrated by computed tomography for each group were superimposed onto standardized matrices. The relationship between the focus and the extent of the lesions and the various symptoms was investigated. Broca aphasics: More than 80% of the group with obvious anarthric components had lesions of the third frontal gyrus involving Broca's area and the lower part of the precental gyrus as well as opercular and insular regions. The size of the lesions of this group was significantly larger than that of the group without marked anarthric components, and the latter was proved to have little localizing value. Wernicke aphasics: The group with poor reading comprehension had cortical and/or subcortical lesions, involving posterior parts of both superior and middle temporal gyri as well as the supramarginal gyrus. On the other hand, lesions of the group with poor auditory comprehension were more anteriorly located and localized in the deep structures. Lesions of the group with poor Token test scores were large and scattered more anteriorly and/or posteriorly compared with those of the group with good Token test scores. Amnestic aphasics: The group with poor naming scores had somewhat larger lesions than the group with good naming scores, and the lesions were scattered about the left hemisphere. The finding has proved that both groups had little localizing value.(ABSTRACT TRUNCATED AT 250 WORDS)