Images in Cardiovascular Medicine Resolution of Expressive Aphasia David D. Spragg, MD A 78-year-old right-handed woman with a history of atrial fibrillation, prior transient ischemic attacks, and cerebrovascular disease developed expressive aphasia. She immediately began writing a note to a companion. Her first 2 attempts (Figure, A and B) demonstrated expressive aphasia with no compromise in motor function. Her third attempt (Figure, C) demonstrated resolution of her aphasia. The 3 notes were written over a course of approximately 15 minutes. The patient was admitted to the hospital, anticoagulated with heparin and warfarin, and discharged without neurological deficit. A transcript of the note follows: I don’t develope whate evdevelope eveope develope I don’t explope to start it redelvpe. I don’t to devdelope to explain what is wrong explain whats wrong with me whats alright I don’t wrong with me. I think I had a stroke. I don’t how to explain what has happened to me. What should I do to me. I couldn’t explain how to explain what I what I want to put into words. I feel much better. I think I can explain what is happening to me. I think I had a small stroke. Figure. Reproduction of 3 successive notes (A, B, and C) written by the patient over a 15-minute period. Disclosures None. From Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, Baltimore, Md. Correspondence to David D. Spragg, MD, Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224. E-mail Dspragg1@jhmi.edu (Circulation. 2009;120:645.) © 2009 American Heart Association, Inc. Circulation is available at http://circ.ahajournals.org DOI: 10.1161/CIRCULATIONAHA.109.855858 Downloaded from http://circ.ahajournals.org/ 645 at NY UNIV MED CTR LIBR on May 17, 2015 Resolution of Expressive Aphasia David D. Spragg Circulation. 2009;120:645 doi: 10.1161/CIRCULATIONAHA.109.855858 Circulation is published by the American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231 Copyright © 2009 American Heart Association, Inc. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539 The online version of this article, along with updated information and services, is located on the World Wide Web at: http://circ.ahajournals.org/content/120/7/645 Permissions: Requests for permissions to reproduce figures, tables, or portions of articles originally published in Circulation can be obtained via RightsLink, a service of the Copyright Clearance Center, not the Editorial Office. Once the online version of the published article for which permission is being requested is located, click Request Permissions in the middle column of the Web page under Services. Further information about this process is available in the Permissions and Rights Question and Answer document. Reprints: Information about reprints can be found online at: http://www.lww.com/reprints Subscriptions: Information about subscribing to Circulation is online at: http://circ.ahajournals.org//subscriptions/ Downloaded from http://circ.ahajournals.org/ at NY UNIV MED CTR LIBR on May 17, 2015