A case of Crossed Aphasia due to Right Frontal Lobe Infarction Concomitant with Moyamoya Disease

Sunaoshi Erika, Ishihara Kenji, Endoh Keiko, Asahi Toshiomi

doi:10.2496/hbfr.43.229

<p> We describe a rare case of crossed aphasia due to right frontal lobe infarction concomitant with moyamoya disease (MMD) , a chronic occlusive cerebrovascular disorder characterized by bilateral stenosis of the supraclinoid portion of the internal carotid arteries with the formation of an abnormal vascular network at the base of the brain. According to our literature search, to date, only two other studies have been reported this condition. A 58-year-old, completely right-handed woman was admitted to our hospital for recovery rehabilitation after cerebral infarction. She was diagnosed with MMD at the age of 44 years. On admission, she had left hemiparesis and speech disorder. Her speech was slow and lacked intonation, with phonological errors and agrammatism. She omitted kana letters when writing, and the aphasia syntax test revealed grammatical errors. She was diagnosed with aphasia characterized by prosodic disorder and agrammatism. Moreover, she exhibited hypergraphia ; however, neither left unilateral spatial neglect nor constructional disorder was observed. Magnetic resonance images of the head revealed infarction in the right frontal lobe including the precentral gyrus. Single-photon emission computed tomography revealed decreased blood flow in the right frontal lobe and left cerebellar hemisphere, suggesting crossed cerebellar diaschisis. Clinical features of aphasia and accompanying symptoms vary among patients with crossed aphasia concomitant with MMD. We speculate that in our case prosody and grammatical functions were located in the right frontal lobe.</p>

A case of Crossed Aphasia due to Right Frontal Lobe Infarction Concomitant with Moyamoya Disease

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