Aphasia

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Aphasia

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A neurologically based language disorder

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Ischemic stroke

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Blood supply to brain is blocked by a thrombus (accumulation) or embolus (traveling mass). 87% of strokes

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Hemorrhagic stroke

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Brain bleed that is intercerebral or extracerebral (in meninges)

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Broca's Aphasia (lesion)

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Damage to Broca's area (44,45) applied be the upper middle cerebral artery

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Broca's Aphasia characteristics

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Telegraphic speech, impaired repetition, good comprehension, impaired articulation, may also have apraxia, dysarthria, right-sided paresis, and depression

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Transcortical motor Aphasia (lesion)

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Anterior superior frontal lobe (Broca's intact) supplied by anterior cerebral artery, and anterior MCA

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Transcortical Motor Aphasia characteristics

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Telegraphic speech, perseveration, good comprehension, good repetition, refusal to repeat nonsense syllables. Motor disorders, apathy/withdrawal.

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Mixed transcortical aphasia (lesion)

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Watershed area- border zone between MCA and anterior and posterior vertebral arteries. Broca's, Wernicke's, and arcuate fasciculus are spared. Somewhat rare

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Mixed transcortical aphasia characteristics

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Impaired fluency, comprehension, severe echolalia, but unimpaired automatic speech (reciting, automatic responses). May also have bilateral Upper motor neuron paralysis, quadriparesis, or visual problems

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Global Aphasia (lesion)

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Extensive lesions in all language areas (perisylvian region). Most commonly supplied by MCA.

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Global Aphasia characteristics

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Profound non-fluent aphasia, impaired repetition, and impaired auditory comprehension. May also have apraxia and right-sided paralysis, paresis, sensory impairment, or neglect.

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Wernicke's aphasia (lesion)

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Wernicke's area, supplied by the posterior branch of MCA

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Wernicke's Aphasia characteristics

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Flowing speech with intact grammar, prosody, and articulation, but empty of content due to word finding and paraphasia. Impaired comprehension and repetition.

Paralysis and paresis uncommon. May also be paranoid, suicidal, or depressed, but less frustrated than Broca's patients.

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Transcortical sensory Aphasia (lesion)

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In tempoparietal region (medial temporal gyrus)

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Transcortical Sensory Aphasia characteristics

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Fluent but empty speech. Intact repetition. Impaired comprehension, repeat nonsense syllables. May have initial hemiparesis or neglect which recovers.

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Conduction Aphasia (lesion)

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Between Broca's and Wernicke's. A rare and controversial diagnosis.

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Conduction Aphasia characteristics

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Impaired repetition. Variable fluency. Paraphasic empty speech. Good auditory comprehension. Buccofacial apraxia. Various or no other motor involvement.

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Anomic Aphasia (lesion)

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Various lesions including angular gyrus, middle temporal gyrus, tempoparietal juncture. Controversial.

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Anomic Aphasia

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Pervasive word finding difficulty, fluent, good auditory comprehension, good repetition, good articulation

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Subcortical Aphasia (lesion)

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Extensive subcortical damage basal ganglia or thalamus.

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Subcortical Aphasia basal ganglia type characteristics

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Fluent, good repetition, good comprehension, impaired articulation, word finding difficulty. May have limb apraxia.

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Subcortical Aphasia thalamus type characteristics

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Single sided motor, sensory, or visual problems. Initial mutism. Severe naming difficulty. Good comprehension, good repetition.