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Case Report
Isolated pure motor apraxia in the setting of depressed skull fracture: A case report and review of the literature
1 Medical Student, Howard University College of Medicine, Washington, DC, USA
2 Department of Surgery, Howard University Hospital, Washington, DC, USA
3 Division of Neurosurgery, Howard University Hospital, Washington, DC, USA
Address correspondence to:
Damirez Fossett
MD, Department of Neurosurgery, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20059,
USA
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Article ID: 101425Z01CH2023
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Harper CN, Prakash K, Fossett D. Isolated pure motor apraxia in the setting of depressed skull fracture: A case report and review of the literature. Int J Case Rep Images 2023;14(2):128–133.ABSTRACT
Introduction: An isolated pure apraxia of speech following head trauma is a rare clinical presentation in the absence of any other neurologic deficit. It is more commonly seen in patients with vascular pathology. Confusion can exist in recognizing an apraxia of speech versus a true Broca’s aphasia. We report such a case in a patient undergoing significant head trauma. The pathology and its management are discussed.
Case Report: A 41-year-old male presented to our Emergency Department with a 3 cm laceration to the left side of the head following an assault with an unknown object. The patient suffered a depressed skull fracture with underlying epidural hematoma, bilateral traumatic subarachnoid hemorrhages, and a resultant isolated pure motor apraxia of speech. He was treated effectively with an emergency frontoparietal craniotomy, elevation and repair of his skull fracture, and evacuation of his epidural hematoma. His pure motor apraxia was greatly improved post-operatively and the patient was referred to outpatient speech therapy with continued neurosurgical follow-up.
Conclusion: This case represents the unusual presentation of a pure motor apraxia of speech following traumatic assault to the left frontoparietal skull. An excellent therapeutic response was obtained following surgical intervention and speech therapy.
Keywords: Apraxia of speech, Broca’s aphasia, Cranial trauma
SUPPORTING INFORMATION
Author Contributions
Cierra N Harper - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Kavita Prakash - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Damirez Fossett - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Cierra N Harper et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
