Characterization of aphasia in aneurysmal subarachnoid hemorrhage

Maranhão, Deborah Karolyne Mendes; Souza, Moysés Loiola Ponte de; Costa, Maria Lúcia Gurgel da; Vieira, Ana Cláudia de Carvalho

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Original Articles • CoDAS 30 (1) • 2018 • https://doi.org/10.1590/2317-1782/20182016225 copy

Characterization of aphasia in aneurysmal subarachnoid hemorrhage

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

Characterize the profile of aphasic syndromes determined by aneurysmal subarachnoid hemorrhage (aSAH) of the left middle cerebral artery (LMCA).

Methods

An analytical, retrospective, cross-sectional study was conducted using a database of cognitive assessments of 193 patients with aSAH admitted to Hospital da Restauração between March 2007 and November 2009. Of these, a total of 26 patients with aSAH in the LMCA territory confirmed by digital angiography were selected. Aphasia was assessed through the Montreal-Toulouse Language Assessment Alpha Version Protocol (Alpha Version) and the CERAD Neuropsychological Test Battery (Verbal fluency).

Results

Language and verbal fluency impairments were identified in patients with aSAH in the LMCA territory when compared with the control population (50 individuals). Of the 26 patients with aSAH, 11 presented aphasic characteristics preoperatively.

Conclusion

The results of this research corroborate the literature, showing that the aSAH frame causes cognitive impairments even in the preoperative phase for aneurysm occlusion. Considering the observed aspects, the predominant aphasic syndromes characterize comprehension aphasia due to sequels in the posterior cerebral artery territory.

Keywords
Subarachnoid Hemorrhage; Aneurysm; Middle Cerebral Artery; Disorders of Language; Aphasia

Variables	Type		p-value
	CONTROL (N=50)	LMCA (N=26)
	Mean ± SD	Mean ± SD
Auditory comprehension (max. score=11)	9.66 ± 1.255	7.69 ± 3.185	0.012 ^* * Mann-Whitney
Repetition (max. score=11)	10.08 ± 0.804	8.54 ± 3.101	0.086^* * Mann-Whitney
Naming (max. score=12)	11.48 ± 0.579	8.85 ± 4.397	0.026 ^* * Mann-Whitney
Written comprehension (max. score=11)	10.53 ± 0.772	8.31 ± 3.198	0.005 ^* * Mann-Whitney
Oral reading (max. score=11)	10.89 ± 0.459	9.25 ± 2.978	0.044 ^* * Mann-Whitney
Semantic verbal fluency	17.76 ± 4.979	8.73 ± 5.668	‹ 0.0001 ^* * Mann-Whitney
Phonological fluency	14.68± 4.623	8.60 ± 4.641	0.0014 ^* * Mann-Whitney
Verbal memory	19.04 ± 3.736	11.45 ± 3.502	‹ 0.0001 ^* * Mann-Whitney

Participants	Gender	Age	Schooling	Dominance	Fisher	Aphasia
1	M	56	0	D	III	Transcortical Sensory
2	M	61	8	D	III	Acquired dyslexia
3	M	73	0	D	IV	Transcortical Sensory
4	F	55	0	D	IV	Wernicke’s
5	F	41	5	D	III	Anomic
6	F	69	0	D	-	Transcortical Sensory
7	F	55	1	D	III	Wernicke’s
8	F	38	5	D	IV	Transcortical Sensory
9	F	43	4	D	IV	Transcortical Sensory
10	F	51	-	D	III	Global
11	F	63	0	D	-	Transcortical Sensory

PATIENT	AGE	SPEECH	AUDITORY COMPREHENSION	REPETITION	NAMING	PARAPHASIA	PERSEVERATION	PERIPHRASIS	JARGON	SEMANTIC FLUENCY ANIMALS	SEMANTIC FLUENCY FRUITS	APHASIA
1	56	F	Dimin.	Adeq.	Good	Y	N	Y	N	11	8	TCS
2	61	F	Adeq.	Adeq.	Good	Y	N	N	N	14	10	AD
3	63	F	Dimin.	Adeq.	Good	Y	Y	N	N	0	0	TCS
4	55	F and Inc.	Poor	Absent	Absent	Y	Y	N	Y	1	2	W
5	41	F	Adeq.	Adeq.	Adeq.	N	N	Y	N	10	11	A
6	69	F	Poor	Adeq.	Good	N	N	N	N	9	3	TCS
7	55	F and Inc.	Poor	Dimin.	Dimin.	Y	Y	N	Y	0	0	W
8	38	F and Inc.	Poor	Adeq.	Absent	Y	Y	N	N	0	0	TCS
9	43	F	Poor	Adeq.	Absent	Y	N	N	Y	0	0	TCS
10	51	NF	Poor	Absent	Absent	Y	Y	N	N	0	0	GL
11	63	F and Inc.	Poor	Adeq.	Poor	Y	Y	N	Y	4	0	TCS

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[1] Conflict of interests: nothing to declare.