APHASIA IN ACUTE STROKE - INCIDENCE, DETERMINANTS, AND RECOVERY

Knowledge of the frequency and remission of aphasia is essential for t he rehabilitation of stroke patients and provides insight into the bra in organization of language. We studied prospectively and consecutivel y an unselected and community-based sample of 881 patients with acute stroke. Assessment of aphasia was done at admission, weekly during the hospital stay, and at a 6-month follow-up using the aphasia score of the Scandinavian Stroke Scale. Thirty-eight percent had aphasia at the time of admission; at discharge 18% had aphasia. Sex was not a determ inant of aphasia in stroke, and no sex difference in the anterior-post erior distribution of lesions was found. The remission curve was steep : Stationary language function in 95% was reached within 2 weeks in th ose with initial mild aphasia, within 6 weeks in those with moderate, and within 10 weeks in those with severe aphasia. A valid prognosis of aphasia could be made within 1 to 4 weeks after the stroke depending on the initial severity of aphasia. Initial severity of aphasia was th e only clinically relevant predictor of aphasia outcome. Sex, handedne ss, and side of stroke lesion were not independent outcome predictors, and the influence of age was minimal.