semantic aphasia（Luria）の1症例

A case study of Luria's semantic aphasia

　症例は69歳男性で，脳梗塞による左頭頂後頭葉損傷例である．患者は当院転院時，一般的な話題の会話では問題なく，神経心理検査においても，書字を除き，発話，聴覚的理解，読解には明らかな成績不良は認められなかった．一方，関係性の理解が困難であり，「三角を丸の下に描いてください」「食事の後，お風呂に入った．どちらが先？」などの課題には正答できなかった．すなわち，Luriaのsemantic aphasiaの症状を呈していた．semantic aphasia は一般的な言語検査ではその症状が抽出されず，見落とされやすい可能性があると考えた．

　We present a case of a 69-year-old male patient exhibiting left parieto-occipital damage resulting from cerebral infarction. When he was transferred to our hospital, the patient demonstrated intact conversational skills. Neuropsychological assessments revealed no apparent deficits in speech, listening, or reading comprehension, with the exception of writing. However, in-depth examinations revealed difficulties in understanding sentences with logical relationships among words. In particular, the patient struggled with tasks such as “Draw a circle under the triangle” and “He took a bath after lunch. Which did he do first?” Based on these findings, we concluded that the patient fulfilled the criteria of Luria's semantic aphasia. We hypothesized that semantic aphasia may be easily overlooked, since its symptoms cannot be detected by standard language tests.