Small dot lesion of transient global amnesia in diffusion-weighted coronal image: Location of the lesion in the hippocampus

role in speechproduction and language processing.Most frequently, cerebralWM lesions are secondary to small vessel disease in patientswith vascular risk factors. We report a 53-year-old right-handed man with history of hypertension and ischemic subcortical lesions, who presented with speech difficulties and memory decline. Methods: Language and cognitive assessment included: Boston Diagnostic Aphasia Examination, BostonNaming Test, Ray Auditory–Verbal Learning Test, Ray–Osterreith Complex Figure Test, TrailMaking Test A andB,Wisconsin Card Sorting Test, Scale for Evaluation of Perceptive Characteristics of Voice and Speech, and Multidimensional Evaluation of Speech and Voice. Results: Brain MRI showed ischemic WM lesions and lacunar infarcts in the brainstem and right cerebellum. Cognitive testing revealed mild cognitive impairment, dominantly affecting attention and executive functions. Speech and language analysis demonstrated subcortical dysphasia, dysarthria and dysphonia with hypophonia, imprecise articulation, short rushes of speech, and palilalia. Cognitive and vocal rehabilitation was carried out, and it led to improvement of comprehension and naming, rhythm and tempo of the speech, articulation and voice intensity and quality. Conclusions: Neurolinguistic and acoustic analysis in patients with ischemic WM lesions can provide additional information in understanding language and speech disturbances, and assist in patient management.