Sol El Baskýn Olguda Sað Hemisferik Ýskemik Ýnme Sonrasý Transkortikal Mix Afazi

Ýnsanlarýn büyük bir kýsmý sað elini dominant kullanýrken, yine bu insanlarýn %90-95’inde de dil hakimiyeti sol hemisferdedir. Sol elini dominant kullanan insanlarýn ise dil hakimiyeti %70’inde sol hemisferdeyken, kalan %30’luk kesimde sað hemisferdedir Biz burada, sol el dominant ve sað hemisfer iskemik inme tanýsý ile takip ettiðimiz ve ender görülen sað hemisfer dil hâkimiyetine baðlý afazi geliþen olguyu sunmayý amaçladýk. Kýrk iki yaþýnda erkek hasta, geceden baþlayan sol kolunda güçsüzlük ve konuþma bozukluðu þikayetleri ile sabah dýþ merkez acil servisine baþvurmuþ. Solunum zorluðu olmasý üzerine entübe edilmiþ ve ilk deðerlendirmede nörolojik muayenesinde bilinç düzeyi stupor, sol nazolabial oluk hafif silik ve kas gücü sol üst ve alt ekstremitede aðrýlý uyaran ile 1/5 düzeyinde hemiparezi ile uyumluydu. Hastanýn yapýlan beyin bilgisayarlý tomografisinde (BT) sað orta serebral arter (OSA) hiperdens olarak izlendi. Difüzyon manyetik rezonans görüntülemede (MRG) OSA sulama alanýnda geniþ difüzyon kýsýtlýlýðý izlendi. Ekstübasyon sonrasý nörolojik muayenesinde GAT-2 afazi testi yapýlan hastada transkortikal mix afazi saptandý. Sol elini kullanan bireylerde sað hemisfer dil hâkimiyetine baðlý afazi çok nadir olduðu bilinmektedir ama literatürde bildirilmiþ vakalar bulunmaktadýr. Bizim olgumuzu deðerlendirdiðimiz GAT-2 Afazi Testi Türkiye’de standardizasyon çalýþmasý yapýlmýþ testler arasýnda yer almaktadýr. Bu yazýda olgu, dil puaný 34 ve motor puaný 13 puan alarak afazi tanýsý aldý. Bizim olgumuzda sað OSA iskemik inme sonrasý transkortikal mix afazi izlenmiþ olup bu yazýda nadir görülen bu klinik antite sunulmuþtur.

Transcortical Mixed Aphasia Following Right Hemisphere Ischemic Stroke In A Left-Handed Patient

While the majority of people use their right hand dominantly, 90-95% of these people also have language dominance in the left hemisphere. In people who use their left hand dominantly, 70% of them have language dominance in the left hemisphere, while the remaining 30% have language dominance in the right hemisphere. In this article, we aimed to present a case that we followed up with the diagnosis of left hand dominant and right hemisphere ischemic stroke and developed aphasia due to right hemisphere language dominance, which is rarely seen. A 42-year-old male patient applied to the external center emergency service in the morning with complaints of weakness in his left arm and speech disorder that started at night. He was intubated due to difficulty breathing and in the first evaluation, in his neurological examination, the consciousness level was stupor, the left nasolabial groove was slightly blurred and muscle strength was compatible with hemiparesis at the level of 1/5 with painful stimulation in the left upper and lower extremities. In the patient's brain computerized tomography (CT), the right middle cerebral artery (MCA) was observed as hyperdense. Diffusion magnetic resonance imaging (MRI) showed extensive diffusion restriction in the MCA irrigation area. In the neurological examination after extubation, the patient underwent GAT-2 aphasia test and was diagnosed with transcortical mixed aphasia. It is known that aphasia due to right hemisphere language dominance is very rare in left-handed individuals, but there are cases reported in the literature. The GAT-2 Aphasia Test, which we evaluated our case, is among the tests for which standardization studies have been conducted in Turkey. In this article, the case was diagnosed with aphasia with a language score of 34 and a motor score of 13. In this case, transcortical mixed aphasia was observed after right MCA ischemic stroke, and this rare clinical entity is presented in this article.