Review
Aphasia after Stroke: Updates into Overcoming The Diagnostic Dilemmas
Samwel Sylvester Msigwa1,✉, Yan Li1 , Xianglin Cheng1,2
1Department of Neurology, The Clinical Medicine School of Yangtze University, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, 434023, China. 2Department of Neurology and Rehabilitation, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, 434023, China.
✉ Correspondence Samwel Sylvester Msigwa, Department of Neurology, The Clinical Medical School of Yangtze University, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, 434023, China. Email: [email protected]. Telephone number: +86 13135752757. Received: November 9, 2020; Accepted: December 2, 2020; Published online: January 17, 2021. Cite this paper: Samwel Sylvester Msigwa, Yan Li , Xianglin Cheng. (2021) Aphasia after stroke: updates into overcoming the diagnostic dilemmas. Global Journal of Neuroscience, 2(1):1-24. https://naturescholars.com/gjn.020101. https://doi.org/10.46633/gjn.020101. Copyright© 2021 by Scholars Publishing, LLC.
Abstract
Aphasia after stroke (AAS) is a decline or impairment of language processing effected by an acquired cerebral lesion leading to significant consequences in all post-stroke phases. Stroke mimics may estimate for up to 1/3 of all critical stroke consultations, with estimated up to 26% and 43% false-negative and false-positive cases, respectively, hence, posing a hurdle to authenticate AAS’s diagnosis. The new literature recommends a triad of questions to deliver during history in chronological order to tackle the diagnostic dilemmas. For AAS assessment, a quick aphasia battery emerges as a time-saving tool to administer in 20 minutes compared to most verified time-consuming tools for a language evaluation. Contemporary research authenticates Oxford cognitive screen as a relevant, fine-tuned screening tool for post-stroke cognitive deficits. Unlike the communication outcome assessment tool facing controversy, consensus regarding suitable tools for quality of life, emotional well-being, and language evaluation exist. Similarly, guidelines for the assessment of AAS-depression comorbidity prevail unestablished. We outlined the practical assessment tools proposed to serve this purpose. Future research is also obliged to appraise these tools in the acute care setting: detailed laboratory investigations and imaging modalities for AAS mimic exclusion covered in this review. However, neuroimaging is the cornerstone for the accurate diagnosis, classification, distinguishing AAS from the mimics, and rehabilitation prognostication.
Key words: Aphasia, Neuroimaging, Comorbidity, Cognition Disorders, Stroke, Referral and Consultation.