Question

Gerald is a 60-year old right-handed man who has suffered a medical cerbral artery infarction that intially resulted in a severe expressive aphasia and right-sided hemiparesis (weakness). After one year of speech therapy, his articulation improved, although it was still somewhat labored. In addition to this, he was severly impared in his ability to name objects. When confronted with pictures, he was only able to name 47 out of 114 pictures. However, he was significantly better at reading words and sentences aloud. He showed no signs of paraphasia (inappropriate word subsitutions), and his writing was only mildly impaired.

Here is an example of a conversation between Gerald and his doctor:

Doctor [holding up a coffee cup]: Can you tell me what this is?

Gerald: Oh boy, you know... isnt that funny, oh i know, its one of those things... geez... its something that you hold, right?... Uhm ... it holds stuff...

Doctor [now showing a pencil]: How about this?

Gerald: Um... ok ... i know what that is ... isnt it something you use to ... you know... oh darn it ... you use it to write, i think ... its one of those things that .... Ugh! ... i must be getting old.

What condition or conditions (there may be more than one possibility) are being described in this case?

Answer 1

Gerald's difficulty in naming objects while maintaining better reading skills and articulation suggests he has anomic aphasia, likely resulting from a lesion in the language network of his left hemisphere, related to his cerebral artery infarction.

Step-by-step explanation:

The condition being described in the case of Gerald, the 60-year old man, is known as anomic aphasia (also called nominal aphasia or amnestic aphasia), which is characterized by difficulties in naming objects. Anomic aphasia is often associated with lesions in the temporal lobe, but can arise from lesions in any area of the language network. Despite difficulties in object naming, patients like Gerald may retain relatively intact grammar, articulate speech, and comprehension. Gerald's preserved ability to read words and sentences aloud suggests that the visual word form area, which is involved in the visual recognition of written words, is likely intact.

Given the history of a cerebral artery infarction (stroke) and resulting right-sided hemiparesis, it is possible that Gerald's stroke affected language areas in the left hemisphere of the brain, which is dominant for language in right-handed individuals. The absence of paraphasia and only mild writing impairment further characterize the specific nature of his language deficit.