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Cerebral hemisphere asymmetry in CT and functional recovery from hemiplegia

From the Department of Physical Therapy, Northeastern University, (Dr. Schenkman), Boston, MA; Department of Neurology, Boston University School of Medicine, Veterans Administration Medical Center (Dr. Butler), Boston, MA; Aphasia Research Center, Department of Neurology, Boston University School of Medicine and Boston VA Medical Center. (Dr. Naeseri, and Department of Radiology, Boston VA Medical Center (Dr. Kleefield).

Cerebra1 hemispheric asymmetries were assessed in relation to motor and functional recovery in nine patients with stroke. All were globally aphasic, assuring similar location and extent of lesion. Initial motor and functional ability were appraised from medical records and compared with neurologic and functional outcome. Frontal and occipital hemispheric widths and lengths were determined from CT. Patients were classified into three groups on the basis of mean combined asymmetry for width (typical asymmetry, atypical asymmetry, and equal symmetry). Patients with the most atypical cerebral asymmetries showed greater recovery than patients in other groups. Two patients with atypical mean occipital asymmetry (width) fared best functionally, whereas the patient who showed the greatest motor recovery had the most atypical mean occipital asymmetry (width). Cerebral asymmetries may contribute to recovery after stroke.

Address correspondence and reprint requests to Dr. Butler. Department of Neurology, Boston University School of Medicine, Medical Center, Boston, MA 02130.

Accepted for publication July 26, 1982

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