Communication disorders in patients with hemispheric intracranial neoplasm

• Main Author: Thomson, Ann-Marie
• Published: University of Edinburgh 1997
• Subjects: 616.8
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.662889

This study was designed to investigate communication impairment due to brain tumour and to identify the effects on language function of biopsy, resective surgery, radiotherapy and chemotherapy. Data were collected from a consecutive series of patients with a tumour of the left hemisphere who were admitted to the Department of Clinical Neurosciences, Western General Hospital, Edinburgh. As disorders of communication may follow damage to the right hemisphere patients with a tumour of the non-dominant hemisphere were also included in the study. A comprehensive language assessment was carried out prior to neurosurgery and again approximately seven days later. Some patients were also assessed before and after radiotherapy and chemotherapy. Neuroradiological data were recorded for each patient. Emotional status was measured before and after treatment and handedness was identified using a recognised inventory. A total of 318 language assessments were carried out on 164 patients. 138 patients had a solitary intracranial tumour. Twenty and six patients respectively formed two separate control groups. The main results from this study are that language disorders were identified in 58% of patients with a tumour of the dominant hemisphere. Dysphasia was more common in patients with malignant tumours. There were significant correlations between location of tumour and type or degree of language deficit; the patterns did not conform to those of localisation of dysphasia seen in patients with stroke. Patients who were dysphasic prior to resective surgery showed significant post-operative improvement while the language of non-dysphasic patients was not damaged by resective surgery. Stereotactic biopsy did not appear to cause dysphasia in patients with a dominant hemispheric tumour; conversely the language of patients who were dysphasic prior to biopsy was often worse after this procedure. Current methods of assessing language impairment in the right hemisphere were found to be inadequate and to require further investigation.