Chapter 15: Language Disorders in Adults

• Stroke (Cerebrovascular Accident, CVA)


  a disruption of blood supply to the brain caused by an occluded (blocked) artery or an artery that has ruptured
• Occulsive (ischemic) Stroke

  a partial or complete blockage (occlusion) of a cerebral artery, causing decreased blood supply to brain tissue
• Hemorrhagic Stroke(Cerebral Hemorrhage)


  a stroke caused by rupturing (hemorrhaging) of a blood vessel that results in blood leaking or flowing into the brain tissue, damaging or killing neurons/axons/dendrites/synapses
• Strokes are the second-leading cause of death worldwide. Heart disease is number one.
• Average age for first stroke is 67 years old
• Men are 1.25x more likely than women to have a stroke
• High blood pressure (hypertension)


  a common disorder in middle age and later in which blood pressure is chronically above 140 over 90 mm Hg
• Infarction


  a localized area of necrotic (dead) tissue resulting from lack of blood supply and oxygen to the tissue
• Necrosis


  the death of cells in an organ or tissue due to disease, injury or failure of the blood supply
• Transient Ischemic Attack (TIA)


  an episode of cerebral vascular insufficiency with partial occlusion of a cerebral artery by atherosclerotic plaque or an embolus, disturbances of vision in one or both eyes, dizziness, weakness, numbness, dysphasia, or unconsciousness may occur. Referred to as a "ministroke" – lasts a few mins to one hour. Beyond one hour would be considered a stroke (not TIA)
• Cerebral Thrombosis (Thrombus)


  an abnormal condition in which a clot (thrombus) develops within a blood vessel
• Atherosclerosis


  a common disorder characterized by yellowish plaques of cholesterol and other lipids (fats) in the inner layers of the walls of arteries, often associated with tobacco use, obesity, hypertension, diabetes mellitus & aging
• Arteriosclerosis


  a common disorder characterized by thickening, hardening, loss of elasticity of arterial walls as a result of buildup of atherosclerotic plaque, leading to decreased blood supply
• Cerebral Embolism (Embolus)


  an abnormal condition in which a blood clot, piece of tumor, or other material (embolus) circulates in the bloodstream until it becomes lodged in a cerebral blood vessel, causing an occlusion; at the location of the occlusion, the embolus begins to function as a thrombus
• Aneurysm


  a localized dilation of a blood vessel wall, resulting in the thinning of the wall at that site (much like a balloon being blown up) and increasing the likelihood of hemorrhaging, especially with high blood pressure
• Spontaneous Recovery


  the physiological healing of the brain's damaged tissue, including reduction of cerebral edema, development of collateral blood vessels and rerouting of neural pathways
• Neuroplasticity (Brain Plasticity)


  the brain's ability to reorganize itself throughout life by forming new neural connections (pathways) through synapses, which allows for new learning and for neurons to compensate for injury and disease, and to adjust their activities in response to new situations or changes in their environment
• Prognosis


  a prediction of the probable course, duration, recovery or termination of a disease or disorder; a prediction of the outcome of a proposed course of treatment, its effectiveness and duration, and the individual's progress
• Most recovery post-stroke happens in first few weeks or months after stroke. Majority of speech and language recovery is within first 6 months
• Tumors (neoplasms)


  Any abnormal growth of new tissue, either benign or malignant, caused by aberrant increases in the rate of cell production
• Toxin


  a substance that poisons or causes inflammation of tissue, including in the central nervous system
• Degenerative Disease


  any condition that causes gradual deterioration of normal body functions
• Receptive Aphasia


  Difficulty comprehending verbal, written, and/or gestural language
• Expressive aphasia


  difficulty formulating verbal, written and/or gestural language
• Fluent Aphasia


  Aphasia that results from damage to posterior regions of the cortex (i.e. temporal or temporal-parietal lesions) and is characterized by language with normal pauses and relatively normal articulation, but with frequent syntactic errors, paraphasias, and circumlocutions.
• Nonfluent Aphasia


  Aphasia that results from damage to anterior cortical regions (i.e. frontal lobe lesions) and is characterized by sparse, perseverative language with disturbed prosody, misarticulations, errors in syntax, and a reduction in phrase length
• Wernicke's Aphasia


  a fluent aphasia caused by damage to regions in or around Wernicke's area in the posterior superior left temporal lobe (i.e. the auditory association cortex). It is characterized by impaired auditory comprehension and verbal expression, and by impaired reading & writing
• Integrate (Integration)


  the process of combining into a complete and functional whole; combining and processing information from the various input modalities to store, attach meaning, and respond
• Anomia


  impaired ability to retrieve (remember) names of people, places, or things as well as to retrieve other parts of speech (verbs & adj) while speaking
• Literal (phonemic) paraphasia


  sounds and syllables that are correctly articulated but may be extraneous, transposed, or substituted, usually with the preservation of the vowels and intended number of syllables in a word (e.g. "tar" for "car"), often occurring in speech & writing
• Verbal (semantic) paraphasia


  unintended substitution of one word for another word that is often semantically related to the intended word (e.g. sister for brother and cat for dog), often occur in both speech & writing
• Jargon Aphasia


  continuous but unintelligible speech with various combinations of literal and verbal paraphasias and neologisms, with little or no conveying of information, often with the speaker having little awareness of the problem and occurring in both speech & writing
• Alexia (acquired dyslexia)


  impaired ability to read as the result of neurological damage
• Agraphia


  an acquired disorder of writing resulting in difficulty writing letters, word & sentences
• Anomic Aphasia


  a disorder whose primary feature is persistent and severe difficulty retrieving names of people, places & objects, as well as all classes of words (verbs, adjs, etc)
• Transcortical Sensory Aphasia


  a rare form of fluent aphasia caused by damage to the left posterior temporal-parietal region of the brain, and characterized by numerous verbal paraphasias and word substitutions, with severe anomia (similar to Wernicke's Aphasia)
• Conduction Aphasia


  a rare form of fluent aphasia from damage to a band of nerve fibers (arcuate fasciculus) that connect Wernicke's area in the left temporal lobe to Broca's area in the left frontal lobe of the brain. Characteristics include difficulty repeating multisyllabic words, phrases, and sentences, phonemic and verbal paraphasias, some word-finding problems, and comprehension that may be impaired
• Broca's Aphasia


  a nonfluent expressive aphasia characterized by agrammatic language with omissions of articles, conjunctions, prepositions, plurals, possessives, and verb morphemes and auxiliary verbs; speech is often limited to high-frequency content words, making it sound telegraphic; apraxia of speech, dysarthria, or both often coexist
• Agrammatism (agrammatic)


  impairment of grammar and syntax and the ability to produce words in their correct sequence and with all necessary morphemes
• Transcortical Motor Aphasia


  the counterpart of transcortical sensory aphasia, with a lesion in the region above and around Broca's area, with characteristics similar to Broca's Aphasia, with the exception that repetition is intact