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Dysarthria in acute ischemic stroke: lesion topography, clinicoradiologic correlation, and etiology
- Source :
- Neurology. 56(8)
- Publication Year :
- 2001
-
Abstract
- Background and purpose: Although dysarthria is a frequent symptom in cerebral ischemia, there is little information on its anatomic specificity, spectrum of associated clinical characteristics, and etiologic mechanisms. Methods: An investigation of 68 consecutive patients with sudden onset of dysarthria due to a single infarction confirmed by MRI or CT was conducted. Results: Dysarthria was associated with a classic lacunar stroke syndrome in 52.9% of patients. Isolated dysarthria and dysarthria–central facial and lingual paresis occurred in 2.9% (n = 2) and 10.3% (n = 7), respectively. Dysarthria–clumsy hand syndrome was observed in 11.7% (n = 8) of patients and associated with pure motor hemiparesis and/or ataxic hemiparesis in 27.9% (n = 19). The lesions were due to small-vessel disease in 52.9% (n = 36), to cardioembolism in 11.8% (n = 8), and to large-vessel disease in only 4.4% (n = 3) of cases. Infarctions were located in the lower part of the primary motor cortex (5.9%; n = 4), middle part of the centrum semiovale (23.5%; n = 16), genu and ventral part of the dorsal segment of the internal capsule (8.8%; n = 6), cerebral peduncle (1.5%; n = 1), base of the pons (30.9%; n = 21), and ventral pontomedullary junction (1.5%; n = 1). Isolated cerebellar infarctions affected the rostral paravermal region in the superior cerebellar artery territory. Conclusions: Extracerebellar infarcts causing dysarthria were located in all patients along the course of the pyramidal tract. This finding correlates with the frequent occurrence of associated pyramidal tract signs in 90.7% (n = 62) of patients. Isolated cerebellar infarcts leading to dysarthria were in all cases located in the territory of the superior cerebellar artery.
- Subjects :
- Adult
Brain Infarction
Male
Pathology
medicine.medical_specialty
Lacunar stroke
Internal capsule
Brain Ischemia
Dysarthria
Internal Capsule
medicine.artery
Internal medicine
Cerebellum
Centrum semiovale
medicine
Humans
Superior cerebellar artery
Aged
Retrospective Studies
Aged, 80 and over
Chi-Square Distribution
business.industry
Cerebral infarction
Cerebral peduncle
Middle Aged
medicine.disease
nervous system diseases
Hemiparesis
Ischemic Attack, Transient
Cardiology
Female
Neurology (clinical)
medicine.symptom
business
Subjects
Details
- ISSN :
- 00283878
- Volume :
- 56
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....3644226390bf80ecd4b2af5a1094b9ad