The purpose of the present study is to report the process of improvement in a female child with aphasia following Reye Syndrome caused by Chickenpox, a rare case in Japan. The disease caused right hemiplegia and disturbance of consciousness. Because of brain edema in the left hemisphere shown by computed tomography, an operation of external decompression was performed. The linguistic condition 20 days after the onset of the disease, when she was 4 years 8 months of age, was near global aphasia with the ability to sing a little along with songs. The language therapy given was 40 minutes about 3 times a week. The development of language before suffering from the disease was normal.
    The Standard Language Test of Aphasia was conducted plural times. The results 3 months after the onset of disease were as follows. Auditory comprehension : words (70 % correct), short sentences (20%), and vocal orders (0%). Production : namings (0%), expressions of verb (0%), and explanations of four serial drawings (none). The results after 9 months after the onset of the disease were as follows. Auditory comprehension : words (100%), short sentences (80%), and vocal orders (40%). Production : namings (85%), expressions of verb (80%), and explanations of four serial drawings (level 4).
    In the process of improvement consistently insufficient auditory comprehension, naming difficulty, repetition disorder, agramatism, and perseveration were observed. In restoring the ability of verb production, the patient vocalized onomatopoeia prior to adult speech, and uttered simple sentences consisting of nouns. In spite of atrophy in the left cerebral hemisphere we could observe improvement, which suggests the flexibility and the immature lateralization of the brain due to the patient's age.

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    Factors which may affect the prognosis of aphasic syndrome, such as age, size of lesion, type of aphasia and recovery pattern during the early stage, were reviewed in 64 patients whose aphasia was caused by cerebral infarction.
    The results are summarized as follows :
    (1) Patients who improved considerably during the first month after onset showed favorable outcome in the long term.
    (2) There was no discernible difference in outcom between Broca's and Wernicke's aphasia.
    (3) Lesion size was found to have a strong relation to the long-range outcome. Of 26 patients with lesion size greater than 50 ccm, 22 (85 %) remained severely affected. In fact, 22 (71 %) of the 31 patients severely affected had lesion size larger than 50 ccm. On the other hand, the size of the lesion in mild aphasics never exceeded 50 ccm.
    (4) Age also seemed to influence the long-term prognosis particularly in patients who were most severely affected during the early stage of stroke.

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