questions 5

Aphasia

Topic updated on 06/05/17 7:52pm

Overview
 

 
Snapshot
  • A 65-year-old woman presents to the emergency department with meaningless speech. The patient was in her usual state of health until 3 hours prior to presentation, where her daughter noticed her mother having "strange speech." On physical examination, her speech is fluent, has paraphasic errors, and comprehension and repetition is impaired. On visual field testing there is a right upper quadrant field-cut. (Wernicke aphasia)
Introduction
 
Aphasia Syndromes
Aphasia
Lesion
Fluency
Comprehension Repetition
Broca (expressive)  
  • A lesion affecting
    • Broca's area (inferior frontal lobe)
      • often secondary to an infarct involving the
        • superior division of the left middle cerebral artery (MCA)
  • No 
  • Yes
  • No
Wernicke (receptive) 
  • A lesion affecting
    • Wernicke's area (superior temporal lobe)
      • often secondary to an infarct involving the
        • inferior division of the left MCA
  • Yes
  • No
  • No
Conduction 
  • A lesion affecting the
    • arcuate fasciculus
      • can be secondary to any lesion involving the
        • peri-Sylvian area
  • Yes
  • Yes
  • No
Global
  • Can be secondary to
    • a proximal MCA occlusion affecting both
      • superior and inferior division of the MCA
    • a large superior division infarct that later becomes a
      • Broca's aphasia
    • large subcortical lesions such as
      • hemorrhages
      • infarcts
  • No
  • No
  • No
Transcortical motor
  • Can be secondary to
    • an anterior cerebral artery (ACA)-MCA watershed infarct
  • No
  • Yes
  • Yes
Transcortical sensory
  • Can be secondary to
    • a posterior cerebral artery (PCA)-MCA watershed infarct
  • Yes
  • No
  • Yes
Transcortical mixed
  • Can be secondary to
    • both an ACA-MCA and PCA-MCA infarct
  • No
  • No
  • Yes
 
 


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