頭頂葉に主病巣を有する伝導失語症の1剖検例

AN AUTOPSY CASE OF CONDUCTION APHASIA PRODUCED BY EXTENSIVE DAMAGE IN THE PARIETAL AREA

緒論

　伝導失語症は1874年Wernickeが理論的に記述したものであり，臨床的には錯語及び模倣言語障碍が強く，言語理解は殆んど正常で，解剖的には言語聴覚中枢と運動中枢との間における連合組織の破壊，即ち，Inselを主とする部分の連合組織の破壊と規定したが，その後多数の症例が報告されて，臨床的にも解剖的にも，彼の考え方は検討せられ，超皮質失語症と共に最も論議される所となつた。即ち臨床的には，言語理解の正常であつたためしは殆んどなく，Liepmann, Pap-penheinは之を感覚失語症の亜型と云い，多くの臨床家もこれを支持している。又解剖的にもInselを含む部分の障害は少く，むしろWernickeの中枢と云われる部分の他に頭頂葉の病巣部のある場合が多く報告せられ，その症状発生機構の不明と共に，解剖的の不明確さが論議の的となつた。Goldsteinは言語の外的手段としての支障による言語障害とは区別して，内言語障害の最もはつきりしたものとして伝導失語症を中心失語症（Central Aphasia）とした。伝導失語症に於て頭頂葉の重要性を始めて云つたのはPötzl （1925）でGoldsteinも之を強調している。

A 79-yeas-old right-handed male patient sud-denly had developed the following syndromes as the result of a vascular cerebral lesion: difficulty in producing automatic series, re-active logorrhoea with numerous paraphasia and gramatical errors, corresponding difficulty in naming objects; gross disability in repeat-ing words and sentences heard, and in under-standing of spoken language: gross inability of understanding of written language; agra-phia and inability to write to dictation, spo-ntaneous writing which were severely dis-turbed, but without any disability in copying; constructional apraxia was not proved with rough examination, disorientation of laterality and slight disturbance of body recognition; complete acalculia which was conparable to the grade of alexia in its consistency and its severity. His affectivity was labile and his thought was so poor that he even could not accomplish simpler subjects in testing. The pacient showed a marked personality change with aggresiveness and paranoid ideas.

The patient died to heart failure after three months.