Vascular syndromes: Revisiting classification of poststroke aphasia

Over 150 years have passed since the first formal description of aphasia associated with localized neurologic damage. In the years since that time, a significant amount of research has been conducted to identify/explain the locations and functions of the brain regions responsible for (or associated with) language as well as to describe the various types of aphasia resulting from injury to these locations. Many of these attempts to associate somewhat predictable patterns of language deficits with damage to specific structures have been confounded by atypical reports and considerable variability in either the behavioral presentation and/or structural damage that directly contradict/oppose some of the proposed theories. However, considering the aphasias as vascular syndromes, or a collection of symptoms associated with damage to various structures supplied by a specific artery, accounts for both the predictability and the variability seen. This chapter presents a brief history of aphasia classification, the vascular territories commonly associated with aphasia, the different aphasic vascular syndromes, and the typical recovery/evolution of aphasia presentation over time.