Back to Top Skip to main content Skip to sub-navigation

Aphasia, Caused by Stroke or TBI, is Frustrating and Little Known

Image of A doctor looking at brain scans. Click to open a larger version of the image. Major Michael Matchette, a 332nd Expeditionary Medical Support Squadron radiologist, reviewed CT scans from a trauma patient to determine the severity of the injuries at the Air Force Theater Hospital in Balad Air Base, Iraq, in February, 2016. The CT scan process goes directly from the scanning machine to the computer, which allows doctors to diagnose medical problems faster. (Photo by: U.S. Air Force photo by Senior Airman Julianne Showalter)

Recommended Content:

Total Force Fitness | Heart Health | Centers of Excellence | Traumatic Brain Injury

Imagine the sudden loss of your ability to understand or express speech, caused by brain damage due to a stroke or a traumatic injury. It includes the inability to read and write, or understand gestures from another person. This devastating condition is called aphasia, and June has been Aphasia Awareness Month.

To add to the frustration of the disease (or in some cases, its saving grace), usually aphasia does not affect a person's intellectual ability. So, a person with aphasia can possibly think perfectly fine, but has no means to communicate those thoughts.

"Most the time people acquire aphasia because of a stroke," said Judy Mikola, a speech pathologist at the National Intrepid Center of Excellence (NICoE) at Walter Reed National Military Medical Center in Bethesda, Maryland. "Since strokes typically occur in elderly people because of cardiovascular problems, incidents of treating and evaluating people with aphasia would be higher in a veterans' hospital. But certainly, it can happen to young people."

Traumatic brain injury, for instance, could be a cause if that language center of the brain was the main area hurt by the injury, Mikola added. If someone sustained a bullet through the brain and it went right through their language center and somehow that person survived, their language is going to be very impaired. For most people, the language center is located in the left frontal temporal region.

Mikola, who has a Ph.D. in speech pathology, said she's currently working with a service member in his mid-30s, who has aphasia due to a cardiovascular disease and an arterial problem. This means blood flow and oxygen to the brain is severely impacted. This particular patient was likely the victim of a hereditary problem, she noted.

"It's a little different for him, but certainly there are a lot of military personnel who don't take as good care of themselves, and are overweight, and eat the wrong kinds of fatty foods that can cause narrowing of their arteries and could lead to heart attack as well as stroke," she said.

Cardiovascular disease, or overall heart health, may affect older people more generally, but outcomes like stroke aphasia occur because of a downturn in fitness much earlier in life, including time on active duty. This is part of the Military Health System's focus on "Total Force Fitness," to keep service members in top shape holistically throughout their military careers.

Typically, aphasia is not seen as a result of blast injuries, Mikola said, though there are exceptions. Even with a car accident, if trauma occurs in that very localized language center of the brain, an aphasia can result. With a condition that causes, say, memory problems, there are multiple areas of the brain that are needed to remember things. With language and recognition of the written word, it's all in one spot.

There is no cure for aphasia, or available surgical options. But in some cases, there is hope.

Diagram of the brain
The National Institutes of Health says there are two broad categories of aphasia: fluent (Wernicke's aphasia) and nonfluent (Broca's aphasia) affecting two spots in the language center of the brain (Photo by: National Institutes of Health)

"Sometimes, when individuals have more of a mild aphasia as a result of stroke or even a car accident, their brain may just heal very well on its own, and some of the aphasia-related problems with speech and language really dissipate over time, especially if they participated in speech therapy," Mikola said. But in general, for those with severe cases, the prognosis is poor.

The ability to talk, listen, read and write can all be impaired differently, or to differing degrees, she said, and so it's vital for patients with aphasia to undergo a speech language evaluation as soon as possible.

According the National Institutes of Health website, "Research has shown that language and communication abilities can continue to improve for many years and are sometimes accompanied by new activity in brain tissue near the damaged area. Some of the factors that may influence the amount of improvement include the cause of the brain injury, the area of the brain that was damaged and its extent, and the age and health of the individual."

The NIH says there are two broad categories of aphasia: fluent (Wernicke's aphasia) and nonfluent (Broca's aphasia), and there are several types within these groups, depending on post-stroke communications abilities.

This pamphlet, called "Moving Forward After a Stroke For Persons with Aphasia," published by the Army Medical Department, spells out in general what aphasia patients must navigate, and recommends who can help. It includes rehabilitative services, but also more day-to-day practical matters, such as memory, intimacy, jobs, managing finances, and driving. Even adjusting to changes in swallowing, drinking and eating sometimes have to be re-learned.

Other sources of information to help family members of the people that have aphasia are the American Speech-Language-Hearing Association, the National Aphasia Association and the American Stroke Association, a division of the American Heart Association that provides resources, strategies and tips on living with aphasia.

"It's a very, very frustrating disorder," Mikola said, to the victims as well as their families.

But there are support groups for survivors of stroke or just aphasia. The above national association websites can provide where to find them.

"There is a period of brain recovery, usually during that first year, where the brain can improve, on its own and more so with therapy, Mikola said.

"So, there is hope for them. And there's a lot of research that is being done with people with aphasia, and there are promising studies that show that with speech therapy, individuals that developed aphasia 10 years ago can still make some improvements with their language abilities, or whichever area they're working on."

You also may be interested in...

One Airmans Recovery from TBI

Video
3/28/2022
One Airmans Recovery from TBI

After a motorcycle accident, Master Sergeant Stalnaker started having symptoms of traumatic brain injury, or TBI. He tells his story about his symptoms and his road to recovery from physical and emotional wounds as a result.

Recommended Content:

Traumatic Brain Injury

A Retired Navy SEAL Discusses his TBI

Video
3/9/2022
A Retired Navy SEAL Discusses his TBI

Retired Navy SEAL Edward Rasmussen discusses his TBI, and urges others to seek treatment if they have symptoms. If you’re experiencing symptoms of TBI, visit health.mil/TBI to learn about the resources available to you.

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury | Brain Injury Awareness Month

One Airman's Recovery from TBI

Video
3/9/2022
One Airman's Recovery from TBI

After a motorcycle accident, Master Sergeant Stalnaker started having symptoms of traumatic brain injury, or TBI. He tells his story about his symptoms and his road to recovery from physical and emotional wounds as a result. If you’re experiencing symptoms of TBI, visit health.mil/TBI to learn about the resources available to you.

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury | Brain Injury Awareness Month

Heart Health Month 2022

Video
2/11/2022
Heart Health Month 2022

Love letter from your heart. Happy Heart Health Month!

Recommended Content:

Heart Health | Total Force Fitness | Heart Health Toolkit

TBI Prevention

Video
2/9/2022
TBI Prevention

It is important for everyone to remember that we only have one brain. That means taking the necessary to protect your brain when engaging in sports, driving, or during exercises while on-duty.

Recommended Content:

Traumatic Brain Injury

Hearing Center of Excellence: Ear Protection

Video
10/26/2021
Hearing Center of Excellence: Ear Protection

Tips for protecting your hearing using the proper protection.

Recommended Content:

Vision and Hearing Loss Prevention | Centers of Excellence | Vision and Hearing Loss Prevention

PRA Training Video 1: PRA Overview

Video
7/22/2021
PRA Training Video 1: PRA Overview

In the first of TBICoE's Progressive Return to Activity (PRA) video training series, you will learn about the reasons for using a progressive return to activity process and receive an overview of the 2021 PRA algorithm and its associated tools. By the end of lesson one, providers will better understand the PRA process, and explain that process to service members diagnosed with concussion. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 2: Six Major Changes

Video
7/22/2021
PRA Training Video 2: Six Major Changes

In this lesson we review the six major changes in the TBICoE's revised 2021 Progressive Return to Activity (PRA) Clinical Recommendation that differ from the original recommendation. The changes reflect the latest TBI research, and will make it easier for providers to manage the recovery process and return service members with concussion to full duty as quickly and safely as possible. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 3: Understanding Relative Rest

Video
7/22/2021
PRA Training Video 3: Understanding Relative Rest

In this lesson we explain the differences between complete rest and relative rest in a staged concussion recovery process, and provide examples of activities that promote relative rest. The revised Progressive Return to Activity (PRA) Clinical Recommendation uses the term 'relative rest' to emphasize the importance of early introduction of physical and cognitive activities that do not provoke symptoms following TBI. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 4: PRA Progression Criteria

Video
7/22/2021
PRA Training Video 4: PRA Progression Criteria

In this lesson, we review the criteria for advancing through the stages of the Progressive Return to Activity (PRA) Clinical Recommendation. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 5: The Six Stages of the PRA

Video
7/22/2021
PRA Training Video 5: The Six Stages of the PRA

In this lesson, we cover the key activity objectives for each of the six stages of the Progressive Return to Activity (PRA) Clinical Recommendation and provide activity examples for each stage. Each stage is designed to gradually increase the intensity and duration of a service member's physical and cognitive activity as they advance in the PRA process. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 6: The Return to Duty Screening

Video
7/22/2021
PRA Training Video 6: The Return to Duty Screening

In this lesson, we cover how to perform the Return to Duty, or RTD screening, which now includes both vestibular/physical and neurocognitive examinations. The purpose of the RTD screening is to objectively measure whether a service member is ready for return to full duty. Each video in the Progressive Return to Activity training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 7: Symptom-Guided Management and Specialty Referral Guidance Tables

Video
7/22/2021
PRA Training Video 7: Symptom-Guided Management and Specialty Referral Guidance Tables

This lesson covers how to use the Progressive Return to Activity, or PRA's Symptom-Guided Management and Specialty Referral Guidance tables. This lesson also details primary care management strategies for service members who are not progressing as expected in the PRA. Each video in the Progressive Return to Activity training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 8: Clinical Case Scenario

Video
7/22/2021
PRA Training Video 8: Clinical Case Scenario

This is an interactive clinical case scenario to test your understanding in applying the Progressive Return to Activity (PRA). We hope this will help medical providers become more familiar with the PRA process when treating service members with concussion. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

Start the Conversation

Video
6/18/2021
Start the Conversation

It’s not always obvious when someone is experiencing depression or thinking about suicide. In this video, learn how you can identify signs of distress and take action by starting the conversation about getting help.

Recommended Content:

Centers of Excellence | Psychological Fitness | Suicide Prevention
<< < 1 2 > >> 
Showing results 1 - 15 Page 1 of 2

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.