Abstract
We followed the progress of a patient of Broca's aphasia due to infarction of the right pre- and post-central gyrus. The patient, a 62-year-old, right-handed male, suddenly developed leftsided weakness and mutism. His auditory comprehension was mostly intact but he showed writing difficulty, predominantly in Kana letters. Despite his poor verbal output, he could sing well. Gradually he began to speak, but two years later his speech was hesitant, effortful and dysprosodic with literal paraphasias. Brain MRI confirmed an infarction of the right pre- and post-central gyrus extending partly to the insula.
Recently, the left (language-dominant) central gyrus has been proposed as a critical site for persistent non-fluent aphasia. In crossed aphasics there are two groups, i. e. an anomalous type and a mirror image type of aphasia resulting from a left (language-dominant) hemisphere lesion. The lesion of the right hemisphere in our patient corresponded to the site of the left hemisphere which causes a typical non-fluent Broca's aphasia. We therefore postulate that crossed Broca's aphasia in our patient represents the mirror image type.
