ABSTRACT

Background

Stroke lesion size and location are understood to be more accurate predictors of recovery from aphasia than demographic variables such as age, education, or socioeconomic status.

Aims

We hypothesise that markedly high premorbid language function can influence functional recovery from aphasia.

Methods & Procedures

This case study reports the recovery of a 64-year-old right-handed male, with large left posterior cerebral artery territory infarct involving the thalamus, occipital lobe and posteromedial temporal lobe. The report is informed by retrospective review of clinical notes, language assessment, and interviews with the participant and his family. Premorbidly, he had acquired fluency in five additional languages in early adulthood, followed by a career in senior roles within corporate communications.

Outcomes & Results

Following severe expressive aphasia in the acute period, the subacute and chronic phases were characterised by residual mild anomia and cognitive communication difficulties apparent on formal assessment, yet masked in functional contexts through compensatory strategies and preservation of an authoritative premorbid communication style.

Conclusions

The current report provides single-case evidence that individuals with markedly high premorbid metalinguistic skills may, in functional contexts, be able to compensate for expressive aphasic deficits and preserve their communicative competence. The discrepancy between the participant’s performance on formal versus informal language assessment underscores the necessity for both perspectives for accurate diagnosis of aphasia. Consideration of premorbid language function can usefully guide clinical decision-making about intervention for individuals with aphasia.

中文翻译：

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病前语言功能：失语症功能结果的预后因素？

摘要

背景

与年龄、教育或社会经济地位等人口变量相比，卒中病变大小和位置被认为是失语恢复的更准确预测指标。

目标

我们假设显着高的病前语言功能会影响失语症的功能恢复。

方法和程序

本案例研究报告了一名 64 岁右利手男性的康复情况，左侧大脑后动脉区域大面积梗死累及丘脑、枕叶和颞叶后内侧。该报告是通过对临床记录、语言评估和与参与者及其家人的访谈的回顾性审查得出的。早在成年早期，他就已经熟练掌握了另外五种语言，随后在企业传播领域担任高级职位。

结果和结果

在急性期出现严重的表达性失语症后，亚急性期和慢性期的特征是在正式评估中明显存在残留的轻度失语和认知交流困难，但通过补偿策略和保持权威的病前交流方式在功能环境中被掩盖。

结论

目前的报告提供了单个案例的证据，表明具有显着高病前元语言技能的个体在功能环境中可能能够弥补表达性失语症的缺陷并保持他们的交际能力。参与者在正式和非正式语言评估中的表现之间的差异强调了两种观点对于准确诊断失语症的必要性。考虑病前语言功能可以有效地指导对失语症患者进行干预的临床决策。