Faculty Bibliography

Five children (three males, two females; four right-, one left-handed; age range 6 to 14 years) who developed aphasia after gross-total excision of left predominantly thalamic tumors are reported. Three patients had Broca aphasia, one had mixed transcortical aphasia, and one patient had conduction aphasia. In the months after surgery, three children improved while receiving radiation and/or chemotherapy, although none recovered completely. Two patients with malignant tumors developed worsening aphasia when the tumor recurred, and later died. Two of three patients tested had visuospatial difficulties in addition to language deficits. Attention and executive functioning were affected in three of three patients tested. Memory, verbal and/or visual functioning, were affected in four of four patients tested. Both patients who were tested showed transient right hemineglect. Two of two patients tested were probably apraxic. The wide range of deficits in these children highlights the importance of the thalamus and other subcortical structures in developing cognition.

The term quality of life (QOL) is used by both scientists and lay persons and is defined in many different ways. One of the major challenges in measuring QOL results from the fact that it is a latent trait not subject to direct observation or countable phenomena. Specific attention to QOL in the stroke survivor has been rare. This paper reviews the literature, identities some of the issues, and reports a study of QOL in 59 consecutively admitted post-stroke aphasic patients who were treated in a comprehensive rehabilitation medicine programme and followed from three to twelve months post onset. The results suggest that improved QOL in aphasic persons of all types in the first poststroke year relates to the intensity and duration of aphasia rehabilitation services which addresses language, communication strategies, copying skills, and psychosocial issues.