26/09/2026
Aphasia 🧠
A disorder of speech & language due to lesions in the dominant hemisphere (usually left).
1️⃣ Key Concepts
➊ Dominant Hemisphere
• 95% right-handed → Left hemisphere
• 60–80% left-handed → Left hemisphere
➋ Common Causes
• Stroke (most common)
• Tumor, abscess
2️⃣ Broca Aphasia (Expressive / Nonfluent)
➊ Lesion
• Broca area (posterior inferior frontal lobe)
• Usually left MCA stroke
➋ Speech
• ↓ Fluency → “telegraphic speech”
• Few words, effortful
➌ Comprehension
• ✅ Intact
➍ Repetition
• ❌ Impaired
➎ Awareness
• ✅ Aware → frustrated patient
➏ Associated Signs
• Contralateral arm/face weakness
➐ Mnemonic
• 🧠 “BROca is BROken”
3️⃣ Wernicke Aphasia (Receptive / Fluent)
➊ Lesion
• Wernicke area (posterior superior temporal lobe)
• Usually inferior MCA stroke
➋ Speech
• ✅ Fluent but nonsensical (“word salad”)
• Neologisms, paraphasias
➌ Comprehension
• ❌ Impaired
➍ Repetition
• ❌ Impaired
➎ Awareness
• ❌ Not aware
➏ Associated Signs
• Cannot follow commands
➐ Mnemonic
• 🧠 “Wernicke is Wordy”
4️⃣ High-Yield Comparison ⚡
➊ Fluency
• Broca → ❌ Nonfluent
• Wernicke → ✅ Fluent
➋ Comprehension
• Broca → ✅
• Wernicke → ❌
➌ Repetition
• ❌ Both impaired
5️⃣ Special Types
➊ Transcortical Motor Aphasia
• Like Broca but repetition intact
➋ Transcortical Sensory Aphasia
• Like Wernicke but repetition intact
6️⃣ Management
➊ Treat underlying cause (e.g., stroke)
➋ Speech therapy (mainstay)
7️⃣ Clinical Pearl ⭐
➊ Frustrated patient → Broca (understands you)
➋ Unconcerned, confused speech → Wernicke
