A case report of A Persian Patient with Crossed Aphasia: agrammatism after right hemisphere damage

Objects: Crossed aphasia (CA) refers to aphasia occurring after right brain damage in dextral. CA is a rare phenomenon in the world and there has not been any report of crossed aphasia in Persian, because of that we aim to report a Persian patient with crossed aphasia and this is a first report of incidence of CA in Persian. In this case report study, we offered a complete report of a 31-year-old right handed man with right hemisphere damage who experienced language disturbances after his brain injury. We assessed the patient with persian version of Bilingual Aphasia Test (BAT), Test of Anomia and Apraxia. In addition, more than 100 utterances of connected speech in three situations (talking about daily activity, describing serial pictures and making egg)were gathered and analyzed. According to the results of anomia and apraxia tests, he was at normal level in both of them, but he couldn’t get complete score in BAT, the worst score was achieved in making sentence subtest of BAT (20%). His performance in the syntactic comprehension, grammaticality judgments, lexical decision, verbal fluency and reading comprehension subtests of BAT was between 60% to 70%. His connected speech was nonfluent (about 30 words per minute) and telegraphic, with 5 words mean length of utterance and omitting or misusing prepositions and deficit in using compound of noun and verb. When he was talking about a topic, he used pronouns ambiguously and selected inappropriate word to convey meaning. Some times he lost topic and had circumlocution. These findings show that his speech was incoherent and non-cohesive, because of grammatical problems(such as deficit in using proposition, complex sentences and discourse marker appropriately) and pragmatic problems(such as circumlocution, deficit in topic maintenance and using pronoun unclearly). According to the role of right hemisphere in processing of pragmatic information in dextral with left hemisphere dominancy for language, this patient show combination of aphasia, specially agrammatism, and right hemisphere damage(pragmatic deficit) together