Aim: To investigate how lesion hemisphere and volume impact 24-hour aphasia recovery.
Methods: Acute Ischemic Stroke patients were retrospectively selected from Liverpool Hospital with a clinical presentation of aphasia and treated with Endovascular Therapy. Their CT Perfusion lesions were classified by hemisphere and then segmented into Core and Penumbral Regions in Grey and White Matter. Patients were dichotomised into those with full aphasia recovery and those still presenting with aphasia at 24 hours.
Results: Of the 34 patients, 15 (44.12%) presented with mild to moderate aphasia while 19 (55.88%) presented with severe aphasia. At 24 hours, 15 (44.12%) had fully recovered from aphasia while 19 (55.88%) patients still presented with aphasia.
Of the 34 patients, 19 (55.88%) had left hemisphere stroke perfusion lesions, while 15 (44.12%) had right hemisphere stroke lesions. Logistic regression showed that left hemisphere lesions were associated with more severe baseline aphasia scores (Odds ratio 55.25, 95% CI: [6.8, 446.1], p<0.001), and a lower chance of aphasia recovery at 24 hours (Odds ratio 5.6, 95% CI: [1.27, 24.64], p=0.023).
Regarding the four regions, GM core, WM core, GM penumbra and WM penumbra, lesion volumes were not significant predictors of aphasia recovery over 24 hours. However, GM core volume did show a trend of smaller lesion volume in patients with full aphasia recovery compared to those still with aphasia at 24 hours (4.96mL±6.95, 13.60mL±22.87, p=0.219).
Conclusion: Lesion hemisphere is a good predictor of aphasia recovery after 24 hours. Lesion volume is a poor predictor of aphasia recovery.