Aphasia Following a Stroke: Causes, Types, and Rehabilitation
As a speech therapist specializing in aphasia, I treat adults both in my office in Malaga and online.
Aphasia is one of the most common acquired language disorders and one of the most profoundly disruptive to the daily lives of patients and their families. It affects the ability to speak, understand, read, and write, and generally occurs as a result of brain injury, most commonly a stroke.
What is aphasia?
Aphasia is an acquired language disorder caused by damage to the brain’s language centers, characterized by difficulties with verbal or written expression, comprehension, or both. The main cause is ischemic stroke, although it can also be caused by traumatic brain injury, a brain tumor, or neurodegenerative diseases.
Symptoms can vary widely: from mild difficulty finding words to an almost complete loss of the ability to communicate.
How often does aphasia occur after a stroke?
A meta-analysis involving more than 168,000 stroke patients found an overall prevalence of aphasia of 34%, with a significantly higher risk in women than in men.
In other words, approximately 1 in 3 people who suffer a stroke will develop some degree of aphasia. This makes aphasia one of the most common neurological sequelae following a stroke.
Types of aphasia
In a sample of 625 patients with post-stroke aphasia, the most common subtypes were Broca’s aphasia (27.2%), anomic aphasia (26.4%), global aphasia (19%), and subcortical aphasia (9.1%).
The main types of conditions that speech-language pathologists assess and treat are:
- Broca’s aphasia: difficulty speaking fluently, halting speech, relatively intact comprehension. The patient knows what they want to say but cannot express it easily.
- Wernicke’s aphasia: fluent speech but with word errors, significant difficulty understanding. The patient may speak a lot but make little sense.
- Global aphasia: the most severe form, which severely impairs both speech production and comprehension.
- Anomic aphasia: difficulty finding the right words (anomia), with comprehension generally intact. It is the mildest and most common form in the chronic phase.
The potential for recovery varies depending on the type of aphasia: Broca’s aphasia has an excellent prognosis for functional recovery, while Wernicke’s aphasia shows more limited recovery, although most patients experience some improvement.
When should I see a speech therapist if I have aphasia?
It is recommended that speech-language assessment begin as soon as possible after a stroke. Signs that indicate the need for consultation include:
- Difficulty finding the right words or expressing oneself in complete sentences
- Speech that is halting, slow, or contains frequent errors
- Difficulty understanding what others say
- Difficulties with reading or writing
- Communication-related frustration or social isolation
Aphasia speech therapist: what to expect from treatment
Early intervention makes all the difference.
A prospective randomized controlled trial involving 123 patients with aphasia following an initial acute ischemic stroke demonstrated that speech therapy initiated within the first two days after the stroke and continued for 21 days promotes the recovery of functional communication.
Aphasia speech therapy includes:
- Detailed assessment of the patient’s language profile
- Lexical retrieval exercises (word finding)
- Exercise on listening and reading comprehension
- Functional and Alternative Communication Strategies
- Support and training for families
Telerehabilitation is an effective option. It is particularly relevant for patients with mobility difficulties: A randomized clinical trial evaluated language telerehabilitation via videoconferencing in patients with post-stroke aphasia, concluding that telerehabilitation augmented by videoconferencing can be a viable model for aphasia rehabilitation with positive effects on linguistic outcomes.
This confirms that online speech therapy sessions are a valid and accessible option for patients with aphasia, especially during the chronic or maintenance phase.
How long does the treatment take?
There is no set timeframe. Recovery from aphasia is an individual process that depends on factors such as the initial severity, the location of the lesion, age, and the intensity of therapy. Some patients achieve nearly complete recovery; others learn strategies to communicate effectively despite ongoing difficulties.
What is clear is that ongoing therapy leads to improvements even years after a stroke, and chronic aphasia also responds to speech therapy.
Speechatherapist specializing in aphasia in Málaga and online
If you or a family member has had a stroke and is having trouble speaking, understanding, or writing, don’t wait to seek help. A speech-language evaluation can help identify the type of aphasia and develop a personalized treatment plan.
I offer speech therapy sessions in Spanish, French and English, both in person at my office in Mijas (Malaga) and online for patients from all over Spain and abroad.
- Tanovic, E., & Tankovic, A. (2010). Incidence and clinical phenomenology of aphasic disorders after stroke. Medical Archives, 64(1), 20–23. https://pubmed.ncbi.nlm.nih.gov/20088173/
- Kim, J. S., & Choi-Kwon, S. (2013). The spectrum of aphasia subtypes and etiology in subacute stroke. Journal of Stroke, 15(2), 133–134. https://pubmed.ncbi.nlm.nih.gov/23680689/
- StatPearls. (2024). Aphasia. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK559315/
- Medscape. (2024). Aphasia: Practice Essentials, Background, Pathophysiology. https://emedicine.medscape.com/article/1135944-overview
- Wang, X., et al. (2024). Meta-analysis and systematic review of the relationship between sex and the risk or incidence of post-stroke aphasia and its types. BMC Geriatrics. https://pmc.ncbi.nlm.nih.gov/articles/PMC10910787/
- Øra, H. P., Kirmess, M., Brady, M. C., Partee, I., Hognestad, R. B., Johannessen, B. B., Thommessen, B., & Becker, F. (2020). The effect of augmented speech-language therapy delivered by telerehabilitation on poststroke aphasia — a pilot randomized controlled trial. Clinical Rehabilitation, 34(3), 369–381. https://pubmed.ncbi.nlm.nih.gov/31903800/
- Godecke, E., Hird, K., Lalor, E. E., Rai, T., & Phillips, M. R. (2012). Very early poststroke aphasia therapy: a pilot randomized controlled efficacy trial. International Journal of Stroke, 7(8), 635–644. https://pmc.ncbi.nlm.nih.gov/articles/PMC3343759/
