Abstract
We reported a case of nonfluent aphasia after cerebral infarction. An 83-year-old, right-handed female exhibited mild anarthria and severely decreased spontaneous speech without impairment of word fluency or sentence composition on any examinations, and she was highly motivated to speak. Comprehension, reading aloud, object naming, and repetition of phonemes, words, and sentences were preserved. An MRI of the brain showed an infarcted lesion in the posterior part of the left middle frontal gyrus and the anterior part of the left precentral gyrus. Although anarthria disappeared soon and she showed some improvement in fluency, she still had difficulty in starting and continuing speech a year after onset. This symptom was more obvious in open questions than in closed questions. Most cases of nonfluent aphasia are known to be caused mainly by anarthria and loss of motivation for speaking. These did not appear to be the reasons for our patient's nonfluency. We discussed impairment of thought, verbalization of thought, and choice of words as possible causes of the nonfluency. Most patients who show Broca's aphasia have lesions in the middle frontal gyrus and in the precentral gyrus in the linguistically dominant hemisphere. Therefore, we believe that this suggests that the cause in this case is one of the causes of nonfluency in Broca's aphasia.
