超皮質性感覚失語症の一剖検例

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  • An Autopsy Case Report on Transcortical Sensory Aphasia

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To date, the dominant posterior boundary zone has generally been considered as the pathological site of transcortical sensory aphasia. Recently, however, we experienced a case that showed transcortical sensory aphasia accompanied by symptoms of left anterior cerebral artery occlusion.<BR>The right-handed patient suffered minimal speech disturbance and mild right hemiparesis about 40 days before a complete stroke. The first CT scan before the stroke showed an unmargined low-density area in the left temporo-occipital region in the territory of the posterior cerebral artery. Then, the patient suffered a complete stroke of the right hemiparesis with crural predominance, accompanied by severe aphasia. The diagnosis of transcortical sensory aphasia was made as a result of the standard language test for aphasia.The second CT scan showed a low-density area in territories of the left anterior cerebral artery as well as the left posterior cerebral artery. The patient died of a maxillary tumor after 1.5 years.<BR>The finding of the autopsy pointed to old infarct of the territories of the left anterior and posterior cerebral arteries, as well as mild left cerebral atrophy due to thrombus of the left internal carotid artery. Because of the simultaneous occurrence of transcortical sensory aphasia and the symptoms of the anterior cerebral artery occlusion, we considered the infarct of the territory of the anterior cerebral artery as the pathological site of the transcortical sensory aphasia for this case.

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