Abstract TP149: Aphasia Recovery After Ischemic Stroke
Background: Establishing aphasia prevalence and outcome after ischemic stroke can facilitate strategies for treatment of aphasia. Few studies of aphasia recovery after ischemic stroke have included consecutive, unselected patients. Our aim was to identify acute and chronic prevalence of aphasia in an unselected consecutive cohort of patients with ischemic stroke. Methods: 218 patients with first-ever acute ischemic stroke were included prospectively and consecutively in the Lund Stroke Register Study. Patients with 1) dementia or psychiatric disorders; 2) non-native Swedish language; or 3) decreased consciousness were not included. Language assessment was made at baseline (within 6 days, median 3 days) after stroke onset by trained research nurses using the NIHSS sub-item 9, “Best Language” to screen for aphasia. Patients with aphasia (score of 1-3 on NIHSS item 9) were re-assessed with NIHSS item 9 by speech and language pathologists at 1 month, 3 months and 12 months after stroke. Results: Of 218 first-ever ischemic stroke patients 52 patients (24%) had aphasia according to NIHSS item 9 (median age 75 years; n=25 female). The distribution of the scores 1-3 at baseline were n=32, n=11, and n=9, respectively. At the 1 year follow-up, 31 patients (67%; n=5 deceased, n=1 drop out) had recovered from aphasia (n=28 with initial NIHSS item 9 score of 1, n=2 with initial NIHSS item 9 score of 2), even though all patients with initial global aphasia (NIHSS item 9 score of 3) had remaining aphasia (NIHSS item 9 score ≥ 1). Figure 1shows aphasia recovery (n=52) according to NIHSS item 9. Conclusions: A majority of patients with mild aphasia recover substantially from aphasia within 1 year after stroke. Patients with initial global aphasia all suffer from remaining aphasia 1 year after stroke. This suggests that this population might especially benefit from an early onset comprehensive, long-term aphasia treatment plan.