At this point, I have only a brief clinical presentation with a few behavioral anecdotes. K.G. is currently in her early fifties and suffered a stroke in 2003. She is extraordinarily independent, and cohabitants with and cares for her blind father in his mid-eighties. K.G. was, and is, an extraordinarily intelligent woman, a member of Mensa (meaning she scored above the 98th percentile on a standardized IQ test) and fiercely self-determining. Coronary and cerebral artery disease caused a piece of atherosclerotic plaque to dislodge from her carotid artery, common etiology for an ischemic stroke. Her stroke six years ago left major non-fluent language deficits (Broca's), minor cognitive reasoning difficulties, and minor right-side hemipelegia, all consistent with left anterior frontal cortex damage. She is able to communicate with labored telegraphic speech and successfully utilizes verb networking and external clue sheets to facilitate communication. Due to her intelligence, apparently largely intact, she becomes extremely frustrated at her inability to succeed at simple tasks. Until I have HIPA clearance and get ahold of the medical records, this is the furthest I can speculate on the clinical presentation.
This is an MRI of an individual that has suffered an ischemic stroke presenting with Broca's aphasia. Each stroke and each patient's neuroanatomy varies, but Broca's and Wernicke's areas of the brain are correlated strongest with language production/motor control and logistics/comprehension, respectively. Broca's aphasia, known as "non-fluent" aphasia, creates labored speech production or an inability to produce speech. Comprehension is usually intact, adding to the frustrating nature of the condition. Telegraphic speech, usually one or two words denoting the gist of the thought, tends to be the average level of communication most Broca's patients can muster. Hemiplegia, or one sided-paralysis, is common because Broca's area is so close to the pre- and primary motor cortex.
Broca's is the most common aphasia, with over 70% of aphasic patients falling under major non-fluent categories. This is because of the complicated vascularization pattern of the brain--Broca's area happens to lie adjacent to a major cerebral artery branching off the carotid artery in the neck. The carotid, like many arteries surrounding the heart, becomes covered in sticky plaque that can attract blood clots. High blood pressure usually causes one of these clots to break off from the diseased artery and cause ischemic damage to the two most vulnerable tissues--the heart and brain.
Science tends to be impersonal, detached, and uncaring. I reject this outright, and it's one of the reasons I love the field of neuropsychology so much. Case-studies, detailed and personal accounts of patients, have little choice but to include emotional developments between a clinician and patient. While I understand the need for double-blind pharmacologic studies, assessing individual therapies on a patient-to-patient basis gives neuropsychology an entirely different aesthetic from other descriptive sciences. I'm looking forward to interacting with K.G. and participating in her therapy. Six years after her stroke, it's highly unlikely that she will regain any major language or motor functions lost from the stroke, but the brain is phenomenally malleable. I know she is an incredibly intellugent person, and her drive in relation to these specific photographic therapies, I can safely assume, will literally rewire parts of her brain. I will be recording as many observations I can throughout this process with the hopes of writing a case-study, but I won't let that devalue the patient herself. This is an amazing opportunity not only for an amateur neuropsychologist, but hopefully for KG as well.
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