Assessment of communication impairment and the effects of resective surgery in solitary, right-sided supratentorial intracranial tumours: a prospective study

• Published in: British journal of neurosurgery Vol. 12; no. 5; pp. 423 - 429
• Main Authors: THOMSON, A-M., TAYLOR, R., WHITTLE, I. R.
• Format: Journal Article
• Language: English
• Published: Abingdon Informa UK Ltd 01.10.1998; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Adult; Aged; Biological and medical sciences; Brain; Brain damage; Brain Tumour Dysphasia Language Surgery; Cognition & reasoning; Dyslexia, Acquired - etiology; Female; Humans; Language; Language Disorders - etiology; Male; Medical sciences; Middle Aged; Neurology; Postoperative Care; Preoperative Care; Speech Disorders - etiology; Supratentorial Neoplasms - complications; Supratentorial Neoplasms - physiopathology; Supratentorial Neoplasms - surgery; Surgery; Tumors; Tumors of the nervous system. Phacomatoses; Human; Postoperative; Intracranial; Western Aphasia Battery; Nervous system diseases; Boston Naming Test Kaplan et al; Neuropsychological test; Right; Exploration; Psychometrics; Language disorder; Cerebral disorder; Communication disorder; Central nervous system disease; Tumor; Neurological disorder
• ISSN: 0268-8697; 1360-046X
• DOI: 10.1080/02688699844628

To assess the effects of solitary, right-sided supratentorial intracranial tumours on language and communication function patients were assessed preoperatively using the Western Aphasia Battery (WAB) and Boston Naming Test (BNT). The impact of resective tumour surgery was evaluated prospectively by a comparison of test scores obtained at pre- and postoperative assessments. The WAB scores in 33 patients revealed that 21% were by definition dysphasic (i.e. Aphasia Quotient 93.8) and 35% obtained an abnormal Language Quotient. Performance was particularly variable on the written picture description and word fluency WAB subtests. Using the BNT 21% of 47 patients were anomic. The tumours were evenly distributed throughout the frontal, temporal and parietal lobes, but none were in the occipital lobe. Reassessment approximately 6 days after excisional tumour surgery showed that mean scores for the BNT, Aphasia Quotient, and the WAB spontaneous speech and comprehension subtests had improved significantly despite a significant reduction in dexamethasone therapy. This study has demonstrated that right-sided intracranial tumours produce subtle, but specific language deficits of a type more usually associated with left-sided brain dysfunction. The pathophysiological basis of these deficits is unclear, but they are not attributable to either limited education or pre-existing dyslexia. Further studies using a discriminating and comprehensive assessment of language in the right hemisphere are required.