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.