Aphasia: how an accident can leave you blank

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 they all have one element in common: a brain alteration that occurs with dysfunctions in any linguistic modality.

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

Likewise, when addressing this type of disorders 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 this new reality for their loved one.

Aphasia, a disorder associated with brain injury

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

The left hemisphere is where, for the most part, linguistic functions are lateralized, although on certain occasions they may have a hemispheric representation. In this way, 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, praxias) and aspects related to the understanding of language. On the other hand, at the subcortical level, the production and understanding of language is enabled 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:

Cerebrovascular accidents (CVA)Craniocerebral trauma. Brain tumors. Nervous system infections.Nutritional and metabolic diseasesDegenerative diseases.

Main causes of neurological alteration

Stroke is one of the main causes of neurological conditions in adults, which is why early recognition of the symptoms is considered vitally important in order to act as quickly and effectively as possible. Cerebrovascular disease corresponds to any alteration in brain functioning caused by some pathological condition of the blood vessels.

Within strokes, we find two large groups:

Ischemia: accidents caused by a decrease or interruption of blood flow in the brain tissue (thrombosis, embolism, arteriosclerosis).Hemorrhages: They are secondary to the rupture of a vessel that allows blood to leak into the brain parenchyma.

Stroke symptoms

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

The most frequent refers to the following:

Loss of strength in an arm or leg, or paralysis of the face (hemiparesis/hemiplegia). Difficulty expressing oneself, understanding what is said or unintelligible language (aphasia). Difficulty walking, loss of balance or coordination.Dizziness, sudden, intense and unusual headache, almost always accompanied by other symptoms. Loss of vision in one or both eyes.

Neuropsychiatric symptoms

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

There is no significant correlation between the presence of depressive symptoms and the etiology and extent of the injury, but rather with the degree of subjective concern for one’s own health status. The temporal pattern of post-stroke depression coincides with the duration of the elaboration of non-pathological grief, which is why we begin to think about the idea of ​​grief as a reaction to the loss of functional dependence.

Anxiety understood as fear or apprehension, accompanied by autonomous physical symptoms, can lead to the presence of 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 using 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 the patient’s maximum functionality.

Final considerations at the social level

We should not give the person greater dependence than they already have. The ideal is to 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, they must be taken into account at all times.

Likewise, and to finish, andIt 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 family member’s adaptation to each daily challenge and problem.

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