Aphasia Flashcards
Wernickes aphasia
Fluent Impaired comprehension, repetition, naming, reading, writing Paraphasias are common, all types Logorrhea Sensory issues Motor intact
Location of wernickes area
Left temporal lobe
Superior posterior
Conduction aphasia location
Left supra marginal gyrus or
Left auditory cortex and insula
Arcuate fasciculus
Conduction aphasia
Fluent Good comprehension and reading @@@Poor repetition@@@ Impaired naming, writing Literal Paraphasias common Awareness of deficits Maybe motor and sensory deficits
Anomic aphasia
Fluent Impaired naming Good comprehension, repetition Reading and writing variable Paraphasias rare Motor good Maybe sensory deficits More posterior -- more involved reading, writing skills
Location anomic aphasia
Left angular gyrus
And, or
Posterior middle gyrus
Location transcortical sensory aphasia
Left frontal areas sparing brocas and arcuate fasciculus
Transcortical sensory aphasia
Fluent Impaired comprehension, naming, reading, writing Good repetition Literal Paraphasias common Known as watershed lesion Sensory and motor likely intact
Location Brocas aphasia
Left inferior posterior frontal lobe
Brocas aphasia
Nonfluent
Agrammatic
Good comprehension
Impaired repetition, naming, reading, writing
Paraphasias rare
In tact sensory
Hemiplegic or hemiparetic due to motor strip proximity
Location global aphasia
Large left perisylvian lesion
Global aphasia
Nonfluent
Poor comprehension, repetition, naming, reading, writing
Paraphasias common
Hemiparesis … Decreased motor, one side
Hemisensory … Decreased sensory on one side
Hemianopsia… Decreased vision on one side
Location transcortical motor
Anterior or superior to Brocas
Extrasylvian region
Upper frontal lobe
Transcortical motor aphasia
Nonfluent Impaired naming, writing Good comprehension, repetition, reading Paraphasias rare Maybe impaired motor Good sensory
Fluent aphasias
Wernickes
Transcortical sensory
Anomic
Conduction
Nonfluent aphasias
Brocas
Global
Transcortical motor
Mixed
Good repetition seen with…
Anomic
Transcortical sensory
Transcortical motor
No repetition
Global Brocas Wernickes Conduction Mixed
Paraphasias common with…
Wernickes
Conduction
Transcortical sensory
Global
Paraphasias rare with
Brocas
Transcortical motor
Anomic
Impaired repetition is key to which type?
Conduction aphasia
Impaired comprehension is key to…
Wernickes
4 most relevant info for prognosis
Initial level of auditory comprehension
Initial level of motor speech impairment
Etiology … TBI is better than stroke
Ability to self correct
Somewhat relevant to prognosis, secondary… 6
Gender Age Health Time post onset for tx initiation Motivation Headaches... Worse if right handed
Not relevant for prognosis…
Premorbid IQ SES Educational level, maybe Race Initial reading and writing skills after stroke
Predictors of outcome … 7
Type, distribution, severity of physical impairment
Cognitive, language, communication ability
Number type and severity of co-morbid conditions
Level of motivation
Coping ability, style
Nature and degree of family supports
Type and quality of adaptation program, training
What tends to improve first?
Receptive and imitative functions
What is spontaneous recovery?
Substitution of functions
Brain reorganization
Natural recovery includes…
Edema, inflammation, reduction of blood flow to brain
Between 1-3 weeks post stroke onset
Sudden inhibition of fx after insult to brain, at a distance from original injury is called….
Passing of disaschisis
As a result of swelling, blood flow, etc
Spontaneous recovery timeline
Biggest in 1-3 weeks
Still good gains from 0-3 months
Verbal skills will still improve past — months post onset
6
Slp should not see/assess patient in first —– to allow initial natural recovery
24-48 hours
Occlusive stroke results in…
Death of brain cells
Hemorrhagic stroke results in…
Displacement of fiber bundles without destroying them
Recovery pattern for occlusive stroke
Greatest change in first 4-6 weeks
Recovery for hemorrhagic stroke
Little change for several months, then rapid improvement
Brocas outcomes…
Variable
Very large regions may persist, little recovery
Milder regions may have early progressive improvement, then form into milder aphasia with anomia
Global outcomes…
Progress slowly
Comprehension improves more than expression
Improvements are slow and over a longer period, making gains up to 1 year post onset
Large lesions… Little recovery
Wernickes outcomes
Variable
Good initial word comprehension associated with…
Better naming
Auditory comprehension deficits…
Not a predictor of auditory comprehension gains
If less severe, better expressive recovery
Do fluent or Nonfluent improve faster?
Nonfluent, expressive
Poorest recovery…
Anomic
Global
Temperoparietal lesion
Best recovery with increased….
Blood flow
tPA
Faster recovery for cortical or sub cortical?
Cortical
