Aphasia is a common symptom of cerebrovascular disease, mainly manifested by the loss of understanding and expression of language, caused by damage to the language centers in the cerebral cortex (dominant hemisphere). There are two language centers: one is called the speech motor center and is located in the posterior part of the inferior frontal gyrus in the dominant hemisphere. This center governs human speech, and if this center is damaged, the patient will lose the ability to speak and will not speak. However, the person can understand the meaning of other people’s speech and often answers questions with gestures or nods. Depending on the extent of the lesion, this can manifest as a complete inability to speak, called complete aphasia. Or, it can only speak single words or words and not speak fluently, called incomplete aphasia. This condition is called motor aphasia. Another center, called the speech sensory center, is located in the posterior part of the superior temporal gyrus in the main lateral hemisphere. This center enables a person to comprehend the meaning of another person’s speech. If this center is damaged, it causes the person to not understand what is being said and to not understand what is being asked. However, such a person can still speak with the speech motor center intact, and sometimes speaks quickly and fluently, but the answer is not the question asked. In clinical practice, we often encounter some cerebrovascular patients who have ipsilateral hemiplegia, but some have aphasia and some do not. This is mainly because the central part of speech is different. There is a medical rule that people who are used to using their right hand to write and hold things are called right-handed, and their language center is in the left hemisphere, which is often called the main hemisphere (dominant hemisphere). On the contrary, if one is accustomed to use the left hand, called left-handed, and the language center is in the right cerebral hemisphere, we call his right cerebral hemisphere the dominant hemisphere. If the right hemisphere is damaged, hemiparesis and aphasia will occur in the left limb. When a person with “right-handedness” has left-sided hemiparesis, no aphasia will occur, and when a person with “left-handedness” has right-sided hemiparesis, no aphasia will occur. Among cerebrovascular diseases, motor aphasia is the most common, followed by sensory aphasia. If the two coexist, it is called mixed aphasia. It is caused by lesions that damage the frontal and temporal lobes of the dominant hemisphere. In addition to the above, there is another type of aphasia, called “naming aphasia”. The patient understands the nature and purpose of the object, but cannot name it. For example, if you point to a toothbrush and ask the patient, “What is this? He will answer “for brushing teeth”. Take a tea pot and ask the patient “What is the name of this”? He said “for drinking water”. The patient understands it in his heart, but he cannot name it, so it is called naming aphasia. The center of naming aphasia is in the posterior temporal lobe and the superior parietal lobe of the dominant hemisphere, and when this part is damaged, the above-mentioned aphasia will occur. Clinical treatment of aphasia 1. Timing of language training In the acute phase of the onset, usually within 3 weeks, aphasia symptoms are unstable, patients are inattentive, restless, impatient or depressed, at this time, attention should be paid to psychological guidance for patients and their families, and effective language communication methods should be taught. Formal language training begins after the acute phase, when the patient has stabilized and can tolerate at least 30 minutes of focused training. Systematic language training generally lasts six months to one year, with a re-evaluation of language function after three months, i.e., an interim assessment. The need for further language training is determined. For those who are in poor general condition, those with progressive disease, those with severe dementia, and those who refuse or do not request training, rehabilitation training may be terminated. The peak recovery period for aphasia is within 3-6 months after the onset of the disease, so it is important to seize this critical period to provide effective rehabilitation training to achieve the best results. It is generally believed that language and body movement disorders have the possibility of recovery within 3 years after the onset of the disease, so do not give up easily, but continue to train for further improvement of function. 2. Common methods of aphasia treatment (1) Traditional stimulation method In the treatment, appropriate and effective oral or written stimulation is given first. Through repeated stimulation, the patient’s corresponding response is elicited, and the correct response is reinforced appropriately. (2) Pragmatics method This type of method can be said to be a development of the stimulation method, which aims to enable patients with language disorders to make maximum use of their residual verbal or nonverbal abilities in order to identify effective methods of communication and thus relate effectively to those around them.