Long-term Outcome Regarding Linguistic and Nonlinguistic Functions in Two Cases of Acquired Aphasia Due to Severe Brain Injury in Childhood

Abstract

The process of improvement and long-term outcome of linguistic and nonlinguistic functions are reported in two cases who had suffered severe traumatic brain injury caused by a serious fall. The first case was a 27-year-old male who had had an accident at 11 years of age. He remained in a coma for four months following evacuation of hematoma. MRI revealed extensive lesions extending across the parietal, temporal and occipital lobes, basal ganglia and thalamus of the left hemisphere. The patient showed severe aphasia, dysarthria and apraxia of speech. He underwent speech therapy for 15 years, and language comprehension and expression abilities showed good recovery. However, word-finding, syntactic processing, and writing or reading deficits were sometimes apparent. The second case was a 10-year-old boy who had had a fall at 3 years of age. CT scan revealed an extensive low-density area in the left frontal, parietal and temporal lobes. The child showed mild aphasia following a coma lasting one week. He was treated by a speech therapist before entering elementary school. At 10 years of age, the child demonstrated recovery of functional communication skills despite the persistence of higher level language deficits, such as difficulties in comprehension and production of complex syntactic structures, and in written language processing. The WISC-R test revealed a verbal IQ of 59 and a performance IQ of 40. Performance levels on the Benton visual memory test and Frostig developmental test of visual perception were lower than the means of normal children. Today both cases continue to show deficits in linguistic and nonlinguistic functions due to the lesions in the left hemisphere, and they require long-term medical treatment and educational support. © 2002, The Japan Society of Logopedics and Phoniatrics. All rights reserved.