Clinical Problem-Solving: Diagnosing Spousal Abuse

To the Editor: Thomas and Lowitt (Aug. 3 issue) 1 describe a 41-year-old female cocaine abuser who presented with an ischemic stroke due to occlusion of the right middle cerebral artery, documented by angiography. As an exercise in clinical problem-solving, this report is incomplete in its presentation and flawed in its conclusions. First, the patient is described as having aphasia and left hemiparesis, a combination that would occur only in a subgroup of left-handed persons with right hemispheric speech dominance. It is therefore essential that information about handedness and characteristics of the speech disturbance be provided. Second, no other neurologic deficits . . .