Stroke-Related Language Complications

 Conditions resulting from stroke damage can vary depending on which area of the brain was affected. Certain areas of the brain are responsible for the production, and synthesis, of language information and if these are damaged as a result of a stroke, the consequent communication problems are referred to as aphasia. There are four main types of aphasia – anomic aphasia, Broca's aphasia, Wernicke's aphasia, and global aphasia - each caused by damage to a different area of the brain.

Anomic Aphasia

Anomia is a condition in which a patient suffers a deficit of expressive language and is the most common, and also least severe form, of aphasia. While a patient with anomic aphasia may struggle to find the right word to describe something, especially nouns and verbs, they have no trouble understanding the speech of others and are able to read adequately, though writing may come with more difficulty.

Broca's Aphasia

Also known as expressive aphasia, this form is the result of damage in the frontal area of the left hemisphere of the brain. This area, known as Broca's area, is thought to be involved in the production of speech and damage to it can result in problems with forming full sentences. Though sufferers of expressive aphasia may be able to produce basic words to convey their message they struggle to form full sentences, often missing out important words, such as prepositions. As well as being unable to produce fluid speech they may also struggle to understand the speech of others.

Wernicke's Aphasia

On the other side of possible aphasic manifestations is Wernicke's, or receptive, aphasia. Occurring when the back section of the left brain hemisphere is affected, Wernicke's aphasia is characterized by difficulty understanding the meaning of written or spoken words. Patients still produce fluent, connected sentences, yet they unknowingly use nonsensical, made up words. They may still understand the flow of another person's speech and can work out from the rhythm of it whether they are asking a question or conveying an emotion, but have no understanding of the meaning of the words used. This is because the affected area, known as Wernicke's area, is thought to be the locus of human language comprehension.

Global Aphasia

Both Broca's and Wernicke's aphasias can vary in degree of severity but the most serious form, global aphasia, occurs when there is widespread language impairment. When both language areas of the left brain hemisphere are damaged, patients lose all language abilities, both in terms of comprehension and production and this form of aphasia most commonly occurs immediately after a stroke.

Often global aphasia is caused by swelling around the brain and may improve as this goes down. Similarly, area-specific language problems may decrease during the post-stroke recovery period. However, in instances where full language abilities are not regained speech and language therapies may be use to try and restore speech or, in extreme cases, to develop alternative ways of communicating.