Acute transcortical mixed aphasia. A carotid occlusion syndrome with pial and watershed infarcts.

摘要: Four of 1,200 consecutive patients with their first stroke showed acute transcortical mixed aphasia (TMA) characterized by nonfluent speech impaired naming, semantic paraphasias, echolalia, comprehension, good repetition, reading, and writing on dictation. All 4 had left internal carotid artery (ICA) occlusion ipsilateral anterior pial territory infarction (precentral-central sulcus territory) watershed between the middle posterior cerebral territories, which spared 'isolated' perisylvian areas. Although rare, TMA is highly suggestive due to ICA occlusion, in that it probably related simultaneous embolism (anterior infarction) haemodynamic insufficiency (posterior infarction).