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KMID : 0359719970150020382
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Journal of the Korean Neurological Association
1997 Volume.15 No. 2 p.382 ~ p.387
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Crossed Aphasia in a Dextral
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Abstract
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Crossed aphasia refers to a combination of aphasia and right hemiparesis in a left handed person or left hemiparesis and aphasia in a dextral. While crossed aphasia is not infrequent at all among left-handers, it remains an extremely rare event
in
dextrals. Its incidence is probably about. 0.4% after right hemispheric lesions and prevalence is about 1% among right-handed aphasics. The neurobiological mechanisms of this phenomenon are unknown, and the neuropsychological correlations are
only
incompletely understood.
We report a case of crossed aphasia in a 61-year-opld right-handed woman whopresented with sudden, severe global aphasia and left hemiplegia without any personal or family history of left-handedness. Brain MR image clearly showed a right
hemispheric
infarction in the territory of the right middle cerebral artery and brain SPECT also displayed reduction of regional cerebral blood flow in the right hemisphere sparing the left hemisphere. In this patient, cerebral dominance for speech seems to
lay in
the right hemisphere, while dominance for limb praxis seems to lay in the left as the patient did not develop right limb apraxia. This case provides evidence that cerebral dominance for speech and handedness in dextrals can be dissociatod. It
also
suggests that crossed aphasia in a dextral may be severe and persisting.
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