Broca's Aphasia - The story of Sarah Scott

Sarah Scott's impressive recovery
from Broca's Aphasia
Reading an English text aloud in the classroom, then 18 year old Sarah suddenly suffered a stroke. Later it will be found that the stroke was most likely caused by a patent foramen ovale. In short, a hole in the heart, which has not been previously detected. Unfortunately this is not such a rare case after all. We all heard stories of young people in their teens or late teen years,  dying as a result of a heart failure and a subsequent stroke. Sarah however, was lucky enough to survive and recover. However, she did not recover fully as she was left with Broca's Aphasia, which is named after the French 19-century surgeon Paul Broca. He was the first to identify Broca's Area, a brain structure central for the production of speech.

So it does not come as a surprise that Broca's Aphasia is a speech disorder which leaves the patient unable or impaired in producing language (oral and written). Interestingly, patients who communicated in sign language before the onset of Broca's Aphasia  are also impaired in their production of sign language. In this case Sarah Scott spoke affluent, halting and with a poor grammatical sentence building after her stroke. An early example can be seen in one of her videos (see below). Since then she has made an impressing recovery thanks to her great willpower and persistence and thanks to a great support by friends, family and the research experts. 

Although one might think that damage to Broca's Area might be the sole underlying cause of Broca's Aphasia it is only true in a classical understanding. Nowadays we know that related language structures may also contribute to the condition. In addition, Broca's Aphasia may not only be caused by a stroke. A brain tumor, cerebral hemorrhage or a extradural hematoma might just as well cause a similar disorder. In certain cases the patient might not even be able to express one single word.  The original patient on which Paul Broca founded his observations was not able to produce any other word than "tan". Hence, since then he is known in medical school books as the patient "Tan".  Generally, it is important to note that the patients are not impaired in their intelligence and normally do know what they want to say, but are unable to do so. 

There are currently about a million of cases like Sarah in the the USA and about 250K cases in the UK. So it is by far not as uncommon as one might just think. Thus, it is great to see a case like Sarah Scott  to go online and present herself in such a difficult life situation. I applaud her for raising awareness for the condition, boosting support and giving hope to many more patients out there. We wish her all the best in her ongoing recovery and  hopefully she will continue with such a determination. Best of Luck!

Sarah Scott 9 months after the stroke. Again important is to remember that she knows the words but is not always able to express them.


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