Crossed Aphasia in a Chinese Bilingual Dextral

A persistent nonfluent aphasia following a right cerebral infarction developed in a 54-year-old right-handed Chinese man. Computerized axial tomography localized the lesion in the distribution of the right middle cerebral artery. The speech and language dysfunction was greater for performances in Chinese than in English, despite the fact that the patient was born in China, was schooled in Chinese until age 7, and spoke Chinese at home and in his business. It is suggested that early learning of Chinese, an ideographic language based on visual spatial percepts, might have been critical for the establishment and maintenance of language dominance in the right hemisphere.