Moyamoya disease is a cerebrovascular pathology characterized by progressive stenosis of the internal carotid arteries and their branches, leading to ischemic and/or hemorrhagic disorders of the cerebral circulation, primarily affecting children and young adults. We present a case of a 23-year-old woman with a history of recurrent cerebrovascular accidents since childhood. Despite experiencing focal motor seizures and transient ischemic attacks, her condition remained undiagnosed until 2006, when, at the age of 7, a digital subtraction angiography revealed characteristic bilateral internal carotid artery occlusions. Subsequent diagnostic challenges and treatments preceded a worsening of symptoms in adulthood, including generalized tonic–clonic seizures. Upon presentation to our clinic, the patient exhibited upper motor neuron syndrome and occipital lobe syndrome, consistent with the disease’s pathophysiology, neuroimaging, and clinical manifestations. Imaging studies confirmed multiple ischemic lesions throughout the cerebral vasculature. Treatment adjustments were made due to the increased incidence of seizures, and the dose of her anti-seizure medication—divalproex sodium—was increased. This case underscores the diagnostic complexities and challenges in managing moyamoya disease, emphasizing the importance of early recognition and prompt intervention.

The present study in Bulgarian volunteers aged 45-55 years focuses on the type and frequency of some vascular risk factors (VRF); it analyzes physical data and results of instrumental investigations (ophthalmoscopy, electrocardiography, Doppler sonography) as well as magnetic resonance imaging (MRI). The study participants have neither subjective memory complaints nor previous cerebrovascular and cardiovascular incidents. The neurological examination and the mental status is normal and VRF are not considered to aff ect their normal daily living. The arterial hypertension (I degree), dyslipidemia and increased LDL-cholesterol correlate with the pathological findings from Doppler/MRI. The regression model explains 35% of the dispersion in statistics and correctly classifies 76.8% of the observations as independent prognostic factors for the presence of abnormal findings from Doppler/MRI at the age from 45 to 55 years, which corresponds to subclinical cerebrovascular disease.

Objective: This study evaluates the clinical applicability of the adapted Bulgarian Scales of Cognitive and Communicative Ability for Neurorehabilitation (SCCAN) for differentiating cognitively healthy older adults from patients with Alzheimer's disease (AD). Methods: Fifty-two participants (31 cognitively healthy, 21 diagnosed with AD) completed the Bulgarian SCCAN and the Mini-Mental State Examination (MMSE). Data analysis included descriptive statistics and Mann–Whitney U tests to examine between-group differences. Results: Significant differences (p < .05) were identified across all SCCAN subtests, particularly in memory, verbal expression, attention, and orientation. The SCCAN demonstrated strong sensitivity to cognitive-communicative deficits and high consistency with MMSE scores. Conclusions: The findings confirm the validity and clinical usefulness of the Bulgarian SCCAN. This instrument provides detailed cognitive-communicative profiling. It can effectively support diagnostic and therapeutic decision-making processes for older adults with neurodegenerative conditions.

Aim: This study evaluated the clinical utility of the Scales of Cognitive and Communicative Ability for Neurorehabilitation (SCCAN) upon assessing Bulgarian in-patients who present with either ischemic stroke or Alzheimer's disease (AD). The aim was to determine whether this tool could detect cognitive-communicative problems that may be missed by customary screening tools. Methods: We conducted two independent pilot studies: one with 14 AD patients, and a second with 19 stroke patients and 31 healthy controls. All participants completed the Bulgarian SCCAN, which assesses eight domains including oral expression, orientation, memory, auditory and reading comprehension, writing, attention, and problem-solving. Stroke and control participants also underwent the Mini-Mental State Examination (MMSE). Descriptive statistics were used so group performance and correlations could be examined. Tests that are non-parametric were also used. Results: SCCAN revealed domain-specific deficits in clinical cohorts. In the AD group, memory and orientation were the most impaired domains. Stroke patients, on the other hand, showed significant impairments, particularly in memory, oral expression, and auditory comprehension, while orientation and attention were relatively preserved. Overall, stroke patients performed significantly better on the SCCAN than the AD group. These findings reveal distinct cognitive–communicative profiles in AD versus stroke populations. Conclusion: SCCAN's Bulgarian version identified cognitive-communicative deficits with clinical sensitivity in patients with AD as well as with those with ischemic stroke. The tool may guide individualized neurorehabilitation and complement standard screening methods. Additional verification is advised.

This study investigated the specific language deficits observed in persons with aphasia through a theoretical analysis of some of the classic and more recent literature in the field. The study used a systematic search and subsequent analysis of publications related to the topic retrieved from well-known electronic databases: PubMed, PsycINFO and Web of Science. The results suggest a nuanced interaction between language components and speech production in persons with aphasia. The theoretical analysis contributes to the understanding of aphasia by highlighting the sophisticated interplay between language processes and speech in individuals affected by this neurologically based communication disorder. It draws the attention of the speech and language pathologist to the need for evidence-based diagnostic and therapeutic interventions tailored to the language profiles of persons with aphasia.