Aphasia: 3 Types That Can Result From Stroke

The Loss of Communication Skills Due to Brain Injury

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Aphasia means you have trouble speaking, writing, or understanding language. Aphasia happens when a part of the brain associated with language (the frontal lobe, the temporal lobe, or the parietal lobe) is damaged.

Aphasia is common after a stroke but can also be caused by a traumatic brain injury, a brain tumor, or an infection of the brain.

This article will focus on the three types of post-stroke aphasia. You will learn how each type of aphasia is different and how post-stroke aphasia is diagnosed.

What Is Aphasia?

The most common cause of aphasia is a stroke because of how the blood vessels are arranged in the brain.

The frontal lobe of your brain controls your cognitive (thinking) abilities, the temporal lobe processes memories, and the parietal lobe is in charge of information about taste, touch, movement, and temperature.

Several regions of the brain control language. The language function is located in one hemisphere (half) of the brain, which is called the dominant hemisphere. Typically, the dominant hemisphere of the brain is on the opposite side as your dominant hand (the hand you write with).

If one of the language regions of the brain is injured but the others are healthy, only some language functions are affected.

Symptoms of Aphasia After a Stroke

People with post-stroke aphasia may have trouble talking or understanding what other people are saying when they're talking. They may also struggle to communicate in other ways like writing.

Symptoms of Aphasia
 Verywell / JR Bee

Some people with aphasia after a stroke are still able to speak but may struggle to "find the right word" when they're talking. They may also start forgetting words or using the wrong words when they talk.

A person with post-stroke aphasia may:

  • Substitute one word for another in a way that doesn't make sense
  • Substitute one sound for another so that a word doesn't make sense
  • Speak in incomplete sentences, often stopping mid-sentence
  • Put words together that don't make sense
  • Writing sentences that don't make sense
  • Use words that are unrecognizable
  • Struggle to find otherwise simple words
  • Have difficulty understanding words or what is being said to them
  • Have difficulty comprehending what they are reading

How Common Is Post-Stroke Aphasia?

About 15% of people under age 65 who have a stroke develop some form of aphasia. Nearly 45% of people over age 85 develop post-stroke aphasia.

Diagnosing Aphasia After a Stroke

Post-stroke aphasia is diagnosed in the same way as aphasia from any other cause. After a physical exam and review of your medical history, imaging studies and evaluative tests would be ordered to help confirm the cause and characterize the nature and severity of the conditions.

Imaging studies typically include:

MRI is the most accurate way to detect signs of a stroke, but a CT scan is faster and more widely available. Healthcare providers often use CT first in people with a suspected stroke and MRI afterward to get a more detailed image.

You would likely be to referred to a speech-language pathologist to undergo a battery of spoken and written tests to characterize the nature and extent of aphasia. The aim of the language assessment tests is to determine if you are able to:

  • Read and write
  • Follow instructions
  • Understand and use words correctly
  • Repeat words that are spoken to you
  • Name common objects
  • Answer to yes or no questions
  • Respond to open-ended questions
  • Answer questions about something you just read
  • Engage in a back-and-forth conversation

3 Types of Post-Stroke Aphasia

There are several well-known aphasia syndromes. Each type of aphasia has its own patterns of speech and language. These are the types of aphasia that would likely occur after a stroke.

Each aphasia pattern relates to the area of the brain that was damaged by a stroke. The three most common types of aphasia are:

  • Broca's aphasia
  • Wernicke's aphasia
  • Global aphasia

Of the three, global aphasia is considered the most severe form as people experience difficulties with all aspects of language, including reading, writing, talking, and comprehension.

Broca's Aphasia

Broca's aphasia was named after the person who discovered the area of the brain responsible for creating speech. Broca's aphasia is also called expressive aphasia or motor aphasia. The term is used to show that the ability to speak is damaged but other language abilities stay mostly the same.

Damage to Broca’s area happens when a stroke interrupts blood flow to the dominant frontal lobe of the brain. Typically, Broca's aphasia prevents a person from forming clear words or sentences but has little or no effect on their ability to understand others when they are speaking.

If you have Broca's aphasia, you might feel frustrated that you cannot turn your thoughts into words. Some people with this type of post-stroke aphasia are only able to say a couple of words—what's called language telegraphic speech.

Broca’s aphasia often occurs with other problems after a stroke because some of the blood vessels affected in Broca’s aphasia also deliver blood to areas of the brain that control the movement of one side of the body (usually the right side).

People with Broca's aphasia after a stroke may also experience:

Wernicke’s Aphasia

Wernicke’s aphasia, also known as receptive aphasia, is named after the person who discovered the areas of the brain that are responsible for our ability to understand language. These areas are located in the temporal lobe of the brain.

People with Wernicke’s aphasia can’t understand others—or even themselves—when they speak.

When people with Wernicke's aphasia after a stroke talk, their speech cannot be understood because they create sentences with words arranged in a random way. This type of language pattern is called logorrhea.

A person with Wernicke's aphasia may say something like: “My door sat through the lamp in the sky.”

Wernicke's aphasia is one of the most emotionally challenging effects of a stroke. When people with Wernicke's aphasia speak, they usually feel as though other people should be able to understand them. They do not realize that their language is impaired.

However, people with Wernicke’s aphasia after a stroke may eventually learn that others cannot understand them when they speak—a realization that can lead to anger, fear, and depression.

Global Aphasia

Global aphasia after a stroke occurs when the brain damage is so widespread that it involves both Broca's and Wernicke’s language areas.

Global aphasia affects all aspects of language, with some people unable to speak or communicate at all. This can affect different domains of language, leading to:

  • An inability to speak
  • Halting speech
  • Difficulty making coherent sentences
  • Trouble understanding others
  • Difficulty understanding fast language
  • Difficulty comprehending things you read
  • Misspelling of words
  • Misuse of grammar
  • An inability to use figurative language

Post-Stroke Aphasia Treatment

The treatment for aphasia after a stroke is similar to how aphasia from other causes is treated. Each person with aphasia has different needs, and not every person with aphasia after a stroke responds to the same kind of treatment. Some people may need to have more than one type of treatment.

For example, a person living with post-stroke aphasia may benefit from:

Unquestionably, the most important aspect of treatment for post-stroke aphasia is speech-language therapy. This can be done with individual or group therapy, with the aim of:

  • Restoring language skills as much as possible
  • Finding alternate means of communication, such as gestures or pictures
  • Using assistive technologies, such as speech-generating devices (SGD) and teletypewriters (TTY)

Some researchers are also exploring whether experimental techniques like deep brain stimulation can help people with aphasia.

Summary

Aphasia is a language disorder that is caused by an injury to specific parts of the brain that control language. Aphasia after a stroke is common but a traumatic brain injury or brain infection can also cause aphasia.

The three kinds of post-stroke aphasia are Broca's aphasia, Wernicke's aphasia, and global aphasia, which all affect your ability to speak and/or understand language. Treatment may include speech-language therapy, medications, counseling, and mental health support.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Brain Injury Association of America. Functions of the brain.

  3. American Speech-Language-Hearing Association. Aphasia.

  4. Sheppard SM, Sebastian R. Diagnosing and managing post-stroke aphasia. Expert Rev Neurother. 2021 Feb;21(2):221–234. doi:10.1080/14737175.2020.1855976

  5. National Institute of Neurological Disorders and Stroke. Aphasia Information Page.

  6. National Aphasia Association. Broca's (Expressive) Aphasia.

  7. National Aphasia Association. Wernicke's (Receptive) Aphasia.

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Additional Reading

By Jose Vega MD, PhD
Jose Vega MD, PhD, is a board-certified neurologist and published researcher specializing in stroke.