Effects of left-sided stroke: Aphasia and language apraxia

Stroke (cerebrovascular accident or CVA) usually affects one side of the brain. Movement and sensation for one side of the body is controlled by the opposite side of the brain.

This means that if your stroke affected the left side of your brain, you will have problems with the right side of your body.

Aphasia

How much trouble you have with aphasia (a-FAY-zha) depends on the type and severity of your brain injury. You may have problems with:

speaking
listening
reading
writing
dealing with numbers
understanding speech
thinking of words with talking or writing.

Aphasia means you have problems speaking and understand language. You may be unable to find the words you need to put sentences together. This is like having a word 'on the tip of your tongue.'

Not all strokes cause aphasia. About 20 percent of stroke survivors have a loss of speech and language.

How stroke affects speech and language

To know why a stroke can cause so many different problems, it is helpful to understand how speech works.

Communicating a message means you think about what you want to say, put your thoughts into words and say the words out loud.
Understanding a message means you know someone wants to say something, you keep the words in mind and put the words together.

Your brain controls the complex steps needed to speak and understand language. That's why injury to the brain -- such as a lack of blood flow during a stroke -- can get in the way of your ability to do these steps.

Different problems result depending on the location and severity of the stroke.

If you have aphasia...

If you have aphasia (a-FAY-zha), you should have your speech and language checked. A speech-language pathologist (or speech therapist) must see how well you can speak and understand. The exam includes four areas:

speaking out loud
writing
listening comprehension
reading comprehension.

You may have problems in some or all four areas. For example, you may have problems reading and writing but not in talking. This exam can also show which areas of speech and language have been least affected.

Language apraxia

When you have language apraxia (aPRAYX-ee-a), you know the right words but you have problems forming words or putting sounds together. Muscle weakness or loss of feeling does not cause this.

If you have mild apraxia, you will have clear speech with inconsistent sound substitutions. For example, a "cup of coffee" may come out as "a puck of pappy" or a "bup of foppe."

If you have severe apraxia, your speech may sound like jargon or y you may only be able to repeat a single syllable or phrase over and over. For example, "do-do-do" or "I dunno."