Neuroimaging and language recovery in stroke

This article reviews the use of a chronic computed tomography (CT) scan (performed after 2 or 3 months following stroke onset) in assessing a patient's potential for recovery of speech and comprehension in the long term (after 6-12 months following stroke onset). Not all aphasia patients recover the ability to produce meaningful speech after a stroke. This article discusses the neuroanatomical areas to be examined on CT scan, in order to predict which stroke patients are not likely to recover meaningful speech, even for as long as 10 years following stroke onset. These neuroanatomical areas are located in deep, subcortical white matter areas; they are not in the cortex. It is important to have information regarding potential for long-term recovery of speech, so that appropriate non-verbal treatment programs can be initiated. A non-verbal computer-assisted treatment program is presented, in which severely affected patients are taught to communicate using pictures and icons on a computer screen.