Anatomoclinical correlations of the aphasias as defined through computerized tomography: Exceptions

We have studied the frequency of exceptions to classical aphasia localizations in right-handed, literate, adult, native speakers of Italian with focal vascular left-hemisphere lesions, correlating clinical and computerized tomography data. Two hundred sixty-seven subjects were given computerized tomography (CT) examinations; lesions were mapped onto lateral diagrams and the sites of the lesions were defined. Patients were then classified as nonfluent aphasics, fluent aphasics, and nonaphasics. Patients with negative CT scans (n = 10) or only "deep" lesions (n = 50) were not studied for anatomoclinical correlations. Of the remaining 207 patients, 36 presented unexpected findings. There were seven cases of fluent aphasia and "anterior" CT lesions and six cases with nonfluent aphasia and "posterior" CT lesions among them. The significance of these findings is discussed.