Abstract
We reported a case of transcortical mixed aphasia due to subcortical hemorrhage from arterio-venous malformation in the left parietooccipital lobe. The subject was a 28-year-old righthanded man admitted to our hospital because of sudden onset of consciousness disturbance. CT scan revealed a hematoma in the subcortical area of the left parietooccipital lobe. Removal of the nidus and hematoma was performed by emergency operation. By 3 weeks after the operation, the patient was alert and had no paresis. Howeves, he suffered right homogenous hemianopia and aphasia. His spontaneous speech was remarkably reduced, and he often had echolalia. His object naming, word fluency, verbal comprehension, reading and writing were all severely disturbed. This contrasted with full preservation of repetition of phonemes and sentences (5~6 words). CT scan 2 months later revealed a lesion in the left parietooccipital lobe. In the CBF (cerebral blood flow) study, xenon-enhanced CT showed a low-flow area in the entire left hemisphere except for the left perisylvian speech areas. We thereby concluded from the clinicoanatomical point of view that the transcortical mixed aphasia may be caused by isolation of the perisylvian speech areas due to disconnecion from surrounding areas.
