Stroke
How does a stroke cause aphasia?
Stroke is the most common cause of aphasia. About one-third of people who have a stroke will also have aphasia.
Strokes are also known as cerebrovascular accidents (CVA). A stroke occurs when the blood supply to the brain is reduced or stopped (ischemic stroke). When this happens, the brain does not receive oxygen and nutrients, which damages the brain’s tissue. Strokes can also be caused by blood vessels rupturing within the brain (hemorrhagic stroke), which also causes damage to brain tissue.
Because the brain has many arteries that supply blood, a stroke typically only affects certain parts of the brain. When blood flow to the brain’s language centers is stopped or disrupted, aphasia can occur.
Usually, aphasia caused by stroke happens quickly and at the same time the stroke occurs. Aphasia symptoms are also most severe right after the stroke.
It’s important to remember that aphasia caused by stroke only affects language, and not intelligence.
Symptoms
How can aphasia appear with a stroke?
The symptoms of aphasia after a stroke can be different depending on the type of stroke and location of the damage to the brain. Symptoms can be severe or mild depending on several factors.
There are three different types of aphasia that are common after a stroke:
- Global aphasia: Difficulty with both understanding language and speaking, writing, or reading, caused by extensive damage to the left side of the brain.
- Expressive aphasia (Broca’s aphasia): Knowing what you want to say but not being able to get the words out.
- Receptive aphasia (Wernicke’s aphasia): Being able to speak relatively clearly, but the words may not make sense, and having a hard time understanding others.
If you have aphasia after a stroke, you may find you have a hard time:
- Speaking in complete sentences (e.g. you might leave out words or only speak in single words at a time)
- Finding the right word (e.g. you might say “apple” instead of “orange”)
- Understanding conversations
- Reading or writing
- Using numbers or doing math
People with aphasia caused by a stroke also often feel tired from trying to communicate.
Brain involvement
Which parts of the brain are affected?
Aphasia caused by a stoke is due to damage to the language centers of the brain. These centers are located in the left hemisphere (side). The main language centers are called Broca’s area and Wernicke’s area. You may have more damage to one than the other, or damage to both.
Diagnosis
How is aphasia related to a stroke diagnosed?
A stroke is diagnosed by medical professionals who will do a series of physical and neurological tests. Your medical team may also take scans of your brain, like a CT scan or MRI, to see which parts of your brain have been affected by the stroke.
They will also have a speech-language pathologist examine you to diagnose aphasia and determine a treatment plan.
Treatment
How is aphasia treated when caused by a stroke?
The most common treatment for aphasia caused by a stroke is speech therapy. A speech-language pathologist will determine a treatment plan, which may include:
- Communication strategies
- Therapy for muscles involved in speech
- Communication tools like AAC devices to help
Your medical provider may also prescribe medications or treatments to treat the physical symptoms of stroke, such as blood thinners or anti-inflammatory medications. There is no medication or medical procedure to treat aphasia.
Recovery and prevention
Can aphasia caused by a stroke improve?
Recovering from aphasia caused by a stroke depends on the severity of the stroke and other underlying factors, such as your overall health, support, and access to therapy. Some people’s aphasia symptoms improve a lot, while others may have communication challenges for a long time. Most people experience the most improvement in the first few months after a stroke.
Speech therapy has been shown to help with recovery. The SLP can also teach you different ways to communicate and help your caregivers or family learn strategies to support you.
Can aphasia related to a stroke be prevented?
You can’t always prevent aphasia related to a stroke, but you can reduce your risk of having a stroke. Medical professionals recommend living a healthy lifestyle to prevent stroke, which means:
- Eating a healthy diet
- Exercising for at least 30 minutes a day
- Limiting sugar and alcohol
- Not smoking
- Getting regular medical checkups
Living with aphasia caused by a stroke
What is it like to live with aphasia?
If you have aphasia caused by a stroke, you may have a hard time communicating with people around you. It may be hard to find the words you want to say, and you may feel confused.
People often use strategies, therapy, and support to participate in daily life after a stroke. An SLP can often help you and your care partners or loved ones find new ways to communicate.
What emotional or psychological effects can occur?
People who have aphasia after a stroke often feel frustrated that they can’t communicate like they used to. They may also feel tired from trying to speak or understand.
Sometimes people with aphasia related to a stroke feel depressed or anxious. They may also withdraw from social situations and feel isolated.
