How Long Is the Recovery of Global Aphasia? Twenty-Five Years of Follow-up in a Patient With Left Hemisphere Stroke

Background. Current knowledge regarding the time course of aphasia recovery is based on observations limited to the first years after stroke. Objective. The authors studied long-term outcome (25 years) of language in a patient with global aphasia. Methods. A 37-year-old man with global aphasia from a large ischemic lesion in the left middle cerebral artery territory was tested 9 times between 3 weeks and 25 years poststroke by means of the Milan Language Examination, Token Test, Raven Test, and apraxia tests. Results. Three main periods of recovery were identified. The first year after stroke was characterized by recovery of verbal comprehension and word repetition. From 1 to 3 years, naming and reading improved. From 3 to 25 years, progressive improvement of previously emerged functions was found, as well as the appearance of spontaneous speech. Conclusions. This unique long-term follow-up shows that the time span for recovery of language functions in global aphasia after stroke may be much longer than previously documented.