J.Jpn. Surg. Soc.. 54(11): 1029-1038, 1954

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Original article

APHASIA FOLLOWING OPERATIVE INTERVENTIONS UPON THE BRAIN

In 17 cases of various brain diseases, in which an operative intervention, for instance, an excision was done somewhere in the aphasic zone of the left cerebral hemisphere, the postoperative occurrence of aphasia was studied in this paper.
1) Aphasia following operation is usually transient, if the wound is not deeply reaching and is defined to the cortical layer.
2) When a wound is made in the neighberhood of Broca's area and is deep enough to reach the wall of a lateral ventricle, the resulting aphasia tends to be persistent. However, if some part elsewhere in the aphasic zone is deeply wounded, the aphasia is not necessarily persisting.
3) Aphasia in cases of a wound in the frontal aphasic zone is mostly motor type, associated with some failure of perception of speech, while in aphasia following a wound in other regions of the aphasic zone, expression and perception of speech are nearly equally disturbed, there being no definite cerebral localization of alexia, nominal, syntactic and semantic defects.
4) It will be seen that a cortical wound everywhere in the aphasic zone gives rise to only transient aphasia, whereas a deeper wound, especially in Broca's region is prone to result in persisting aphasia.
Recovery of aphasia seems to take place due to the functional compensation mainly by the neighboring brain area and only in the severest cases by the cerebral hemisphere of the opposite side.
In view of these facts, it may be unreasonable to postulate one or another speech center in a small circumscribed area of the cerebral cortex from the observations on residual aphasias in old traumatic cases, because not only the organic damage, but also the disturbances of functional compensation are the essential cause of the residual aphasia.
(author's abstract)

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