Clinical criteria to rule out cervical-spine injury.
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Biomedical subjects
Publications and source records attributed to R S April.
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This chapter describes methods of clinical history taking and examination of the PLDD candidate with lumbar radicular symptoms. It stresses features of the classical neurological examination of the back and lower extremities in a concise, systematic fashion.
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A persistent nonfluent aphasia following a right cerebral infarction developed in a 74-year-old right-handed Chinese man. Computerized axial tomography localized the lesion in the right frontal lobe. This case is similar to a previously reported one, also with crossed aphasia in a bilingual and dextral Chinese person. Despite these two independent observations and in spite of the fact that unusual cerebral organization might be related to early learning of a nonalphabetic (ideographic) language, preliminary sampling has failed to demonstrate a greater incidence of crossed aphasia in two separate Chinese populations.
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A persistent nonfluent aphasia following a right cerebral infarction developed in a 54-year-old right-handed Chinese man. Computerized axial tomography localized the lesion in the distribution of the right middle cerebral artery. The speech and language dysfunction was greater for performances in Chinese than in English, despite the fact that the patient was born in China, was schooled in Chinese until age 7, and spoke Chinese at home and in his business. It is suggested that early learning of Chinese, an ideographic language based on visual spatial percepts, might have been critical for the establishment and maintenance of language dominance in the right hemisphere.
An interesting case of systemic lupus erythematosus (SLE) is presented in which the clinical onset of myelopathy strongly suggested demyelinating disease. Later, intracranial hypertension developed on two occasions. Postmortem examination showed the systemic lesions of SLE. In addition, demyelinating lesions were found in the spinal cord and the optic nerve, the neuropathologic picutre of Devic's syndrome, a variant of multiple sclerosis. We question whether some of the cases showing necrotic myelopathy might have an autoimmune pathogenesis.
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Two right-handed bilingual (English and Cantonese) Chinese patients were observed to have crossed aphasia. A preliminary study of a multiracial population with left hemiplegia did not show a higher incidence of aphasia in Chinese subjects. These two extremely rare cases are interesting examples of a particular type of cerebral organization of language.