Language recovery in aphasic stroke patients: Clinical, CT and CBF studies

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Abstract
This paper reviews a number of studies with aphasic stroke patients after the acute stage. It is suggested that the main pathophysiological mechanism of recovery is a cortical functional reorganization involving both hemispheres and that the participation of the various cortical areas in the recovery process is not uniformly efficient. In some categories of aphasia there is a partial shift of language towards the right hemisphere. It is noted that information concerning the prognosis can be obtained from the analysis of the initial clinical picture (type and severity of aphasia), from CTScan data (size of the lesion when the infarct is cortico-subcortical) and from rCBF studies during functional tests. In general, the presence of widespread and important activation patterns in the left hemisphere characterizes the patients with a good prognosis and, moreover, in each clinical category of aphasia, the activation of some particular regions proves necessary for a good recovery.