Özet:

In this study, the prognostic value of Tc-99m HMPAO brain SPECT and CT was investigated in patients with aphasia due to cerebral infarct, in the acute and subacute periods of ischemic stroke. For this purpose, 8 female and 12 male patients (age range: 45-85 years) were taken. Gulhane Afazi Test (GAT) was performed on the acute period and between 12-15 days after stroke for classification of developing aphasia. The results of GAT were evaluated both by CT and Tc 99m HMPAO brain SPECT done on the period between 7-10 days after the first neurological examination. Of 20 patients, 9 had global, 4 Broca, 3 Wernicke, 2 anomic and 2 transcortical sensorial aphasia. All cases had lesions localised in the left hemisphere revealed by CT studies. Fourteen cases had various localised cortlco-subcortical infarct areas and 6 had subcortical lesions without cortical involvement. In all cases, it was determined that cerebral hypoperfusion dedected by SPECT was at the same site with morpohogical lesion detected by CT. Of the hypoperfused areas, 6 (30%) were equal to and 14 (70%) were greater than the structural lesions detected by CT. In four cases (20% ) was detected cross cerebellar hypoperfusion that might be linked to the diachisis. As a conclusion, the study revealed that the functional lesion was greater than the structural lesion in most of the cases with aphasia due to cerebral infarct. It was suggested that SPECT (one of the functional imaging methods) together morphological imaging methods such as CT might be useful for more detailed information and more accurate classification of aphasic syndromes. In addition, our findings suggest that aphasia types which could not be described by anatomical lesions detected by CT might be linked to functional lesions assessed by SPECT, which was greater than structural lesions detected by CT. Diachisis may be responsible for this condition.

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