Aphasia, caused by stroke or traumatic brain injury, is frustrating and little known (2024)
Maj. Michael Matchette, a radiologist with the 332nd Expeditionary Medical Support Squadron, reviews CT scans of a trauma patient to determine the severity of injuries at the Air Force Theater Hospital at Balad Air Base, Iraq, in February 2016. The CT scanning process goes directly from the scanning machine to the computer, allowing doctors to diagnose medical problems faster. (Photo: U.S. Air Force photo by Senior Airman Julianne Showalter)
Imagine the sudden loss of your ability to understand or express speech caused by brain damage from a stroke or traumatic injury. It involves the inability to read and write or understand the gestures of another person. This devastating condition is called aphasia, and June was Aphasia Month.
To add to the frustration of the disease (or in some cases its saving grace), aphasia usually does not affect a person's intellectual abilities. So someone with aphasia may be able to think perfectly, but has no means to convey those thoughts.
“Most often, people develop aphasia as a result of a stroke,” says Judy Mikola, a speech pathologist at the National Intrepid Center of Excellence (NICoE) at Walter Reed National Military Medical Center in Bethesda, Maryland. "Since strokes typically occur in older people due to cardiovascular problems, the incidence of treating and evaluating people with aphasia will be higher in a veterans hospital. But it can certainly happen to young people as well."
For example, traumatic brain injury could be a cause if the language center of the brain was the main area injured by the injury, Mikola added. If someone were to take a bullet to the brain and it went straight through their language center and that person somehow survived, their language would be severely affected. In most people, the language center is located in the left frontal temporal region.
Mikola, who has a Ph.D. in speech pathology, said she is currently working with a service member in her mid-30s who has aphasia due to cardiovascular disease and an arterial problem. This means that blood flow and oxygen to the brain are severely affected. This particular patient was likely the victim of a hereditary problem, she noted.
“It's a little different for him, but there are certainly a lot of service members who don't take care of themselves, are overweight and eat the wrong kind of fatty foods, which can cause narrowing of their blood vessels and lead to heart attacks. as well as strokes,” she said.
Cardiovascular disease, or in generalheart health, can affect older people in general, but outcomes such as stroke aphasia occur due to a decline in fitness much earlier in life, including time on active duty. This is part of the military healthcare system's focus on “Total strength fitness”, to holistically keep soldiers in top shape throughout their military career.
Typically, aphasia is not seen as a result of blast injuries, Mikola said, although there are exceptions. Even a car accident can result if the trauma occurs in the highly localized language center of the brain. In case of a condition e.g. Memory problems: There are different parts of the brain that are needed to remember things. With language and recognition of the written word, it's all collected in one place.
There is no cure for aphasia or surgical options available. But in some cases there is hope.
Aphasia usually happens suddenly after a stroke or a head injury. But it can also come on gradually from a slow-growing brain tumor or a disease that causes progressive, permanent damage (degenerative). The severity of aphasia depends on a number of things, including the cause and the extent of the brain damage.
Even with a car accident, if trauma occurs in that very localized language center of the brain, an aphasia can result. With a condition that causes, say, memory problems, there are multiple areas of the brain that are needed to remember things.
Understandably, feelings of confusion and frustration are normal for people with aphasia. “They try to read something and can't recognize the words,” says Cherney. “Or they try to say something, and it comes out sounding like gibberish.” People with fluent aphasia also often struggle to understand what others say.
The recommended treatment for aphasia is usually speech and language therapy. Sometimes aphasia improves on its own without treatment. This treatment is carried out by a speech and language therapist (SLT). If you were admitted to hospital, there should be a speech and language therapy team there.
There aren't any cures for the disorder and it doesn't directly cause death, though the life expectancy after onset is usually between seven and 12 years.
Some people with aphasia fully recover without treatment.But for most people, some amount of aphasia typically remains. Speech therapy can often help recover some speech and language functions over time. But many people continue to have problems communicating.
It remains unclear whether aphasia impacts fitness-to-drive; however, people with aphasia face barriers in returning to driving due to: (1) uncertainty regarding the role of language in driving; (2) poor awareness and knowledge of aphasia, and (3) communication demands in the patient-journey and assessment.
It's most often caused by strokes in the left side of the brain that control speech and language. People with aphasia may struggle with communicating in daily activities at home, socially or at work.
People with Broca's aphasia may understand speech and know what they want to say, but they frequently speak in short phrases that are produced with great effort. They often omit small words, such as "is," "and" and "the."
The ability to recognize aphasia can aid in the diagnosis of its underlining cause. For example, patients with an acute stroke can initially present with aphasia and can be misdiagnosed as delirium.
You qualify for disability benefits under the listing if you're unable to: Speak or write effectively due to expressive aphasia (difficulty forming words, also called motor aphasia) or sensory aphasia (characterized by fluent, nonsensical speech and the inability to understand, also called receptive aphasia).
A brain MRI can help diagnose primary progressive aphasia. The test can detect shrinking of specific areas of the brain. MRI scans also can detect strokes, tumors or other conditions that affect brain function.
The aphasia usually gets better or goes away entirely as you recover and your brain heals with time and treatment. For people who have long-term or permanent brain damage, like what happens with severe strokes, speech therapy can sometimes help a person's language abilities.
Preparing for your appointment. If your aphasia is due to a stroke or head injury, you'll probably first be seen in an emergency room.. You'll then see a doctor who specializes in disorders of the nervous system (neurologist), and you may eventually be referred to a speech-language pathologist for rehabilitation.
Many people have aphasia after a stroke. Both men and women are affected equally. Aphasia can occur at any age. It is most commonly seen in those over 65 years of age.
The aphasia usually gets better or goes away entirely as you recover and your brain heals with time and treatment. For people who have long-term or permanent brain damage, like what happens with severe strokes, speech therapy can sometimes help a person's language abilities.
Aphasia usually occurs suddenly, often following a stroke or head injury, but it may also develop slowly, as the result of a brain tumor or a progressive neurological disease. The disorder impairs the expression and understanding of language as well as reading and writing.
People with primary progressive aphasia eventually lose the ability to speak and write. This may take anywhere from 3 to 15 years. They also have trouble understanding written and spoken language. Some people are not able to form sounds to speak, even when they still have the ability to write and comprehend language.
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Maj. Michael Matchette, a radiologist with the 332nd Expeditionary Medical Support Squadron, reviews CT scans of a trauma patient to determine the severity of injuries at the Air Force Theater Hospital at Balad Air Base, Iraq, in February 2016. The CT scanning process goes directly from the scanning machine to the computer, allowing doctors to diagnose medical problems faster. (Photo: U.S. Air Force photo by Senior Airman Julianne Showalter)