From the Guidelines
Intracranial hemorrhage can cause several speech changes, including aphasia, dysarthria, anomia, and apraxia of speech, depending on the location and extent of bleeding, as reported in studies such as 1 and 1.
Speech Changes After Intracranial Hemorrhage
The specific pattern of speech changes depends on which brain regions are affected. For example:
- Damage to Broca's area in the frontal lobe typically causes expressive aphasia with halting, effortful speech.
- Damage to Wernicke's area in the temporal lobe leads to fluent but nonsensical speech with poor comprehension.
Common Speech Disturbances
Common speech disturbances after intracranial hemorrhage include:
- Aphasia (difficulty understanding or expressing language)
- Dysarthria (slurred or unclear speech due to muscle weakness)
- Anomia (difficulty naming objects)
- Apraxia of speech (trouble coordinating speech movements)
Recovery and Rehabilitation
Recovery varies widely, with some patients showing significant improvement through speech therapy while others experience persistent deficits, as noted in 1 and 1. Speech changes often occur alongside other neurological symptoms like facial weakness, difficulty swallowing, or limb weakness. These speech changes occur because the hemorrhage disrupts neural networks responsible for language processing and the motor control of speech muscles, either through direct damage or pressure effects on surrounding brain tissue.
Importance of Rehabilitation
Rehabilitation has an important role in promoting recovery and readjustment to the illness in ICH survivors, as emphasized in 1. However, there are few data on the natural long-term course and degree of recovery after ICH, frequency of the various ICH-related impairments, and their evolution over time.
Recent Guidelines
Recent guidelines, such as those reported in 1, highlight the importance of individualized care and rehabilitation plans for patients with intracranial hemorrhage, taking into account the location and extent of bleeding, as well as the patient's overall health and functional status.
From the Research
Speech Changes after Intracranial Hemorrhage
Speech changes can occur after an intracranial hemorrhage, including various types of aphasia. The following are some examples of speech changes that can occur:
- Broca's aphasia: characterized by non-fluent speech, poor articulation, and phonemic paraphasia with anarthria, but with preserved ability to repeat short sentences and read words aloud 2
- Broca area's aphasia: characterized by fluent speech, normal articulation, verbal paraphasia, and speech perseveration, but with preserved ability to repeat short sentences and read words aloud 2
- Receptive or global aphasia: characterized by impaired comprehension, which can affect brain activation to motor commands and lead to false negative results in cognitive motor dissociation (CMD) testing 3
- Occult aphasia: can be a major factor in false negative CMD results, particularly in clinically unresponsive patients 3
Factors Influencing Speech Changes
Several factors can influence the occurrence and severity of speech changes after an intracranial hemorrhage, including:
- Location and extent of the hematoma: lesions in the left frontal lobe, operculum, and insula cortex can affect speech and language abilities 2
- Type of aphasia: different types of aphasia can have different effects on speech and language abilities 2, 3
- Timing of assessment: speech changes can vary over time, with some studies showing improvements or declines in language abilities at different time points after the hemorrhage 4, 5
- Underlying arteriopathies: classification of the underlying arteriopathies can help tailor prevention strategies and improve outcomes 6