Aphasia: how an accident can leave you blank

Aphasia: how an accident can leave you blank

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Aphasia is a language disorder caused by brain damage. Despite the fact that it has problems in communication and expression, it is common that hemiplegia and motor alterations also appear.

Problems in communication, in articulation, speech or intonation of words and even in reading or writing. Few language disorders are as complex as aphasia. There are different types, but all of them have one element in common: a brain disorder that occurs with dysfunctions in any language modality.

On the other hand, there is an important aspect that we must understand. The aphasic patient does not only present a language problem. This clinical condition is often associated with a brain injury, hence other functional alterations may exist; for example, hemiplegia. In these cases, it is essential to always have a good neuropsychological evaluation.

Also, when dealing with this type of disorder we must always apply a multidisciplinary approach. Thus, in addition to the neurologist, the person with aphasia needs their doctor, neuropsychologists, occupational therapists, physical therapists, social workers, nurses, etc. The family must also have the support of professionals to know how to help and assume that the new reality of their loved one.

Most people with aphasia are between 60 and 70 years old, however, aphasia can occur at any age.

Aphasia, a disorder associated with a brain injury

Aphasia is described as an alteration of the ability to use language or acquired loss of language as a result of a brain injury. Consequently, aphasia is understood as an acquired disorder in the ability to produce oral language.

In the left hemisphere where, for the most part, linguistic functions are lateralized, although on certain occasions they may have a hemispheric representation. Thus, language has a cortical and subcortical component.

At the cortical level, we find specific areas that control motor aspects of speech (movements for the oral production of sounds, articulation, praxis) and aspects related to language comprehension.

On the other hand, at the subcortical level, the production and understanding of language are made possible by other cognitive functions such as attention, working memory, long-term memory, and executive functions.

What causes aphasia?

The normal functioning of the brain can be affected by different neurological pathologies. Thus, among the main neurological alterations that can lead to language disorders, we find:

Stroke (CVA)

Head injury.

Brain tumors

Infections of the nervous system.

Nutritional and metabolic diseases

Degenerative diseases.

Main causes of neurological alteration

LCA is one of the main causes of neurological conditions in adults, so it is considered vitally important early recognition of symptoms in order to act as quickly and effectively as possible. Vascular brain disease corresponds to any alteration in brain functioning caused by a pathological condition of the blood vessels.

Within the LCAs, we find two large groups:

Ischemia: accidents caused due to the decrease or interruption of blood flow in brain tissue (thrombosis, embolism, arteriosclerosis).

Hemorrhages: they are secondary to the rupture of a vessel that allows the filtration of blood into the cerebral parenchyma.

LCA Symptomatology

The appearance of stroke is quite characteristic: a focal neurological deficit occurs suddenly (hemiplegia, aphasia ...). Even so, the symptoms depend largely on the location of brain involvement.

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The most frequently refers to the following:

Loss of strength in an arm or leg, or paralysis of the face (hemiparesis/hemiplegia).

Difficulty in expressing oneself, understanding what is said or unintelligible language (aphasia).

Difficulty walking, loss of balance or coordination.

Dizziness, sudden, severe and unusual headache, almost always accompanied by other symptoms.

Loss of vision in one or both eyes.

Neuropsychiatric symptomatology

The probability of suffering from post-stroke depression is greater between the first three months and the twelve after the stroke and begins to reduce thereafter. Between one third and half of the patients who have a stroke develop depressive symptoms related to feelings of sadness and isolation, irritability, sleep disorders and indifference towards therapy.

There is no significant correlation between the presence of the depressive condition and the etiology and extent of the lesion, but with the degree of subjective concern for one's own state of health. The temporal pattern of post-stroke depression coincides with the duration of the elaboration of a non-pathological duel, so the idea of ​​grief begins to be thought of as a reaction to the loss of functional dependence.

Anxiety understood with fear or apprehension, accompanied by autonomous physical symptoms, can lead to the presence of a Generalized Anxiety Disorder between 1 and 30% of cases. This symptomatology appears as the presence of dysfunctional cognitions related to the fact of having suffered a stroke and its future consequences.

Neuropsychological intervention in stroke

A neuropsychological evaluation is carried out through standardized tests in order to develop the patient's cognitive profile. Based on this profile, an intervention plan is established and the rehabilitation of the affected cognitive functions is carried out through the use of substitute, compensatory or restorative methods in order to achieve maximum patient functionality.

Final considerations at the social level

We should not give the person a greater dependence on what he already has. Ideally, maintain an effective communication system that allows you to express your feelings and desires. On the other hand, we must not forget the needs and interests of the person, it must be taken into account at all times.

Also, and finally, it is appropriate to offer adequate support to the family so that they know at all times how to act to reduce anxiety and facilitate the adaptation of the family to each challenge and daily problem.

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