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Aphasia is an (acquired/developmental?) disorder of symbolic communication (aka language). It is a dysfunction of the (dominant/non-dominant?) hemisphere for language. Is right hemisphere damage diagnosed as aphasia?
What does it mean by "aphasia is a syndrome"?
- No (non-dominant hemisphere)
cluster of symptoms/variety of manifestations
Key points of aphasia
Impaired comprehension or expression?
Multimodality disorder: explain
Symptoms are influenced by physiological inefficiency and/or impaired cognition. What is aphasia not a product of?
- Typically both
- any language modality may be compromised
- Dementia, sensory loss, motor impairments
- sensory=hearing, motor=glossectomy
What does the competence model say?
The performance model?
- Aphasia is loss of linguistic knowledge (have to reteach the word)
- Aphasia is an access problem (use compensatory strategies like cuing, writing it out)
What are the 5 components contributing to the performance model?
- Aphasia is transient (seizures, migraines)
- co-existing impairments (attention, WM, EF)
- aphasic-normal continuum (mistakes aphasic people make are similar to non-aphasic; quantitative difference, not qualitative like misspellings)
- Stimulability of aphasic individuals (providing first sound)
- Variability of aphasic behavior (within individual)
Prevalence in US?
How many each year dx with aphasia? (# from 1981)
How many stroke patients will end up with aphasia?
Is there great general knowledge of aphasia?
- 1 million
- 95% right handed=LH dominant, 70% left handed=LH dominant)
- Equal across genders
- Elderly more aphasic (more likely for CVA; Wernicke's more than aphasia in elderly)
Who termed the connection between damage and "speech amnesia" in 1770?
Paul Broca present ___ in 1865 to recognize relationship between brain and language. He published the basis of localizing language (speaking) to the ___ hemisphere. This was radical.
This person described receptive aphasia in 1874. he identified auditory comprehension area, ___. 1st person to come up with neurological model of language
This person was a contemporary of Broca. He said "to localize the damage which destroys speech and to locate speech are two different things" warning about specifying specific locations to specific functions (areas perform different functions).
Emotional (automatic)= intact (RH, hi, how are you) vs. intellectual (controlled) language= not intact; LH.
This person wrote Aphasia and Kindred Disorders of Speech (1926). It was the 1st book on aphasia relating to syntax/grammar and classifications of aphasias. He was the first to develop a battery of tests for evaluating aphasia.
- Tan; Left
- Carl Wernicke
- Hughlings Jackson
- Henry Head
What is a stroke/brain attack?
What (rank) cause of death is it?
Risk factors for CVA?
What is the "stroke belt"? Stroke buckle?
- Disruption of blood flow to the brain
- Facial droop, severe headache, slurred speech, loss of consciousness, numbness on one side, nausea/vomiting
- Smoking (narrows vessels), poor diet, high BP, Medications, alcohol, athersclerosis, diabetes, African American, TIA, obesity, depression
- Southeast; due to lifestyle factors/diet
- NC, SC, Georgia
CVA in Children
When are kids most likely to have CVA?
What type is most likely?
- 1st 30 days of life
Ischemic stroke (the occlusion, cause)
Most common in elders or kids?
Causes cell death, aka ___ (damaged brain tissue, the result)
What is the core?
What is the penumbra?
- part of the brain tissue that is damaged that can't be reversed
- neural tissue around the core that is functionally suppressed with stroke (acute CVA treatment tries to save this; without tx, may become part of core)
2 types of ischemic strokes
This type is associated with atherosclerotic disease (plaque buildup). Can take minutes or weeks. Blockages are at bifurcations (junctions) because they're more narrow=more turbulence at the bend.
treatment for this type of ischemic CVA
What is the procedure for clearing of a vessel?
This type of ischemic CVA occurs when a clot from somewhere else in the circulatory system breaks off and travels into the vasculature.
What is the most common source of clots? Is this type gradual or abrupt?
Treatment for this type of CVA?
- endarterectomy (risky..could dislodge plaque)
- Anti-platelet meds, aspirin
- Embolic stroke
- Heart; abrupt
- Anti-coagulants, anti-platelets
Other causes of ischemic CVA
Inflammation of vessels=
Inflammation of arteries=
Inflammation covering the brain=
- sickle-cell anemia (easier for clots to form)