Overview Snapshot A 65-year-old woman presents to the emergency department with meaningless speech. The patient was in her usual state of health until 3 hours prior to presentation, where her daughter noticed her mother having "strange speech." On physical examination, her speech is fluent, has paraphasic errors, and comprehension and repetition is impaired. On visual field testing there is a right upper quadrant field-cut. (Wernicke aphasia) Introduction Aphasia SyndromesAphasiaLesionFluencyComprehensionRepetitionBroca (expressive)A lesion affectingBroca area (inferior frontal lobe)often secondary to an infarct involving thesuperior division of the left middle cerebral artery (MCA)NoYesNoWernicke (receptive)A lesion affectingWernicke area (superior temporal lobe)often secondary to an infarct involving theinferior division of the left MCAYesNoNoConductionA lesion affecting thearcuate fasciculuscan be secondary to any lesion involving theperi-Sylvian areaYesYesNoGlobalCan be secondary toa proximal MCA occlusion affecting bothsuperior and inferior division of the MCAa large superior division infarct that later becomes aBroca's aphasialarge subcortical lesions such ashemorrhagesinfarctsNoNoNoTranscortical motorCan be secondary toan anterior cerebral artery (ACA)-MCA watershed infarctNoYesYesTranscortical sensoryCan be secondary toa posterior cerebral artery (PCA)-MCA watershed infarctYesNoYesTranscortical mixedCan be secondary toboth an ACA-MCA and PCA-MCA infarctNoNoYes Aphasia SyndromesAphasiaLesionFluencyComprehensionRepetitionBroca (expressive)A lesion affectingBroca area (inferior frontal lobe)often secondary to an infarct involving thesuperior division of the left middle cerebral artery (MCA)NoYesNoWernicke (receptive)A lesion affectingWernicke area (superior temporal lobe)often secondary to an infarct involving theinferior division of the left MCAYesNoNoConductionA lesion affecting thearcuate fasciculuscan be secondary to any lesion involving theperi-Sylvian areaYesYesNoGlobalCan be secondary toa proximal MCA occlusion affecting bothsuperior and inferior division of the MCAa large superior division infarct that later becomes aBroca's aphasialarge subcortical lesions such ashemorrhagesinfarctsNoNoNoTranscortical motorCan be secondary toan anterior cerebral artery (ACA)-MCA watershed infarctNoYesYesTranscortical sensoryCan be secondary toa posterior cerebral artery (PCA)-MCA watershed infarctYesNoYesTranscortical mixedCan be secondary toboth an ACA-MCA and PCA-MCA infarctNoNoYes
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All Videos (0) Neurology | Aphasia Neurology - Aphasia Listen Now 17:5 min 6/17/2021 96 plays 0.0 (0)