Investigation of the diagnostic value of aphasia and sensory-motor sings for topographic detection of lesions in the patients with cerebrovascular syndrome

Determination of diagnostic value of neurologic syndromes for neurotopographic diagnosis of lesions of central nervous system may decrease unnecessary neuroimaging and its costs.
In this study, 200 patients who had undergone brain MRI and had a single new well defined cerebrovascular lesion in the brain underwent neuroexamination and were categorized based on syndrome diagnosis. This clinical evaluation was performed by a neurologist who was blind to the result of brain MRI. Also, the topography of vascular and parenchymal lesions was reported by a neuroradiologist who was blind to the clinical data. Then, true, false positive and false negative cases were identified compared to the standard method for determination of lesions topography; i.e., brain MRI. Afterwards, sensitivity, specificity, positive and negative predictive values, and accuracy of these syndromes were assessed.
The diagnostic accuracy of broca and wernicke aphasia for localization of brain lesion in lateral left frontal and left temporoparietal was 94%. Besides, the accuracy of hemiparesis for localization of brain lesion in the contralateral hemisphere was 95%. Additionally, the accuracy of aphasia and hemihypoesthesia for localization of brain lesion in the left hemisphere and contralateral hemisphere was 100%.
Topography of symptomatic cerebrovascular lesions could be more accurately determined using clinical neuroexamination skills for detection of neurological syndromes.