Prognosis of Putaminal Hemorrhage: SLTA (Standard Language Test of Aphasia) Follow up Study and CT Classification

CT scans of 21 cases of left-sided putaminal hemorrhage were classified into four types, i.e., Type I, IIa, IIm and lip and the degree of aphasia was evaluated by the SLTA, 1, 3, 6 and 12 months from onset. As a rule, surgery was selected for the treatment of large hemorrhages (above 4-5 cm in the longest diameter). A characteristic aphasic pattern of each type of hemorrhage was found as follows; Type I hemorrhage: All cases of Type I hemorrhage, both operative and conservative cases, had good recovery and fell into the normal range of standard deviation on the SLTA by 3 months from onset. Type I Ia hemorrhage: This type of hemorrhage showed diffuse and severe impairment on the SLTA and had poor recovery. Type IIm hemorrhage: Both hearing and speech were moderately impaired on the SLTA, but the former had good recovery. Type IIp hemorrhage: Large hemorrhages showed various degrees of impairment on the SLTA in accordance with the size of hemorrhages. Hearing was predominantly impaired but later recovered. Impairment in speech remained. Reading was usually not so remarkably impaired on the SLTA in Type I, Type IIm and Type Hp. Each type showed various degrees of recovery by 3 months from onset, after which further recoveries were gradual and Small slight. The CT classification of the putaminal hemorrhage might make it possible to predict recovery in speech functions.