Background: To study the characteristics of vascular aphasia in a cohort of patients with a first-ever stroke. Methods: All patients admitted to the Lausanne neurology department for a first-ever stroke between 1979 and 2004 were included. Neurological examination including language was performed on admission. Stroke risk factors, stroke origin and location, associated symptoms and Rankin scale scores were recorded for each patient. The influence of these factors on aphasia frequency and subtypes was analyzed using logistic regression models. Results: 1,541 (26%) of patients included in this study had aphasia. The more frequent clinical presentations were expressive-receptive aphasia (38%) and mainly expressive aphasia (37%), whereas mainly receptive aphasia was less frequently observed (25%). In ischemic stroke, the frequency of aphasia increased with age (55% of nonaphasic vs. 61% of aphasic patients were more than 65 years old), female sex (40% of women in the nonaphasia group vs. 44% in the aphasia group) and risk factors for cardioembolic origin (coronary heart disease 20 vs. 26% and atrial fibrillation 15 vs. 24%). Stroke aphasia was more likely associated with superficial middle cerebral artery (MCA) stroke and leads to relevant disability. Clinical subtypes depended on stroke location and associated symptoms. Exceptions to the classic clinical-topographic correlations were not rare (26%). Finally, significant differences were found for patients with crossed aphasia in terms of stroke origin and aphasia subtypes. Conclusions: Risk factors for stroke aphasia are age, cardioembolic origin and superficial MCA stroke. Exceptions to classic clinical-topographic correlations are not rare. Stroke aphasia is associated with relevant disability. Stroke location and associated symptoms strongly influence aphasia subtypes.

Murray CJ, Lopez AD: Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997;349:1436–1442.
Brust JC, Shafer SQ, Richter RW, Bruun B: Aphasia in acute stroke. Stroke 1976;7:167–174.
Wade DT, Hewer RL, David RM, Enderby PM: Aphasia after stroke: natural history and associated deficits. J Neurol Neurosurg Psychiatry 1986;49:11–16.
Pedersen PM, Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS: Aphasia in acute stroke: incidence, determinants, and recovery. Ann Neurol 1995;38:659–666.
Godefroy O, Dubois C, Debachy B, Leclerc M, Kreisler A: Vascular aphasias: main characteristics of patients hospitalized in acute stroke units. Stroke 2002;33:702–705.
Laska AC, Hellblom A, Murray V, Kahan T, Von Arbin M: Aphasia in acute stroke and relation to outcome. J Intern Med 2001;249:413–422.
Hier DB, Yoon WB, Mohr JP, Price TR, Wolf PA: Gender and aphasia in the Stroke Data Bank. Brain Lang 1994;47:155–167.
Ferro JM, Madureira S: Aphasia type, age and cerebral infarct localisation. J Neurol 1997;244:505–509.
Yamamoto H, Matsumoto M, Hashikawa K, Hori M: Stroke onset and courses; in Bogousslavsky J, Caplan L (eds): Stroke Syndromes. Cambridge, Cambridge University Press, 2001, pp 3–7.
Croquelois A, Wintermark M, Reichhart M, Meuli R, Bogousslavsky J: Aphasia in hyperacute stroke: language follows brain penumbra dynamics. Ann Neurol 2003;54:321–329.
Kreisler A, Godefroy O, Delmaire C, et al: The anatomy of aphasia revisited. Neurology 2000;54:1117–1123.
Basso A, Lecours AR, Moraschini S, Vanier M: Anatomoclinical correlations of the aphasias as defined through computerized tomography: exceptions. Brain Lang 1985;26:201–229.
Pedersen PM, Vinter K, Olsen TS: Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovasc Dis 2004;17:35–43.
Bogousslavsky J, Cachin C, Regli F, Despland PA, Van MG, Kappenberger L: Cardiac sources of embolism and cerebral infarction – clinical consequences and vascular concomitants: the Lausanne Stroke Registry. Neurology 1991;41:855–859.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.