A patient has a lesion in the right hemisphere involving the arcuate fasciculus. The expected language deficit is:

• A Broca's aphasia — non-fluent speech with good comprehension
• B Wernicke's aphasia — fluent but incomprehensible speech
• C Transcortical motor aphasia — non-fluent with intact repetition
• D Conduction aphasia — fluent speech with poor repetition ✓

Explanation

The arcuate fasciculus is a white matter tract connecting Wernicke's area (posterior superior temporal gyrus) to Broca's area (inferior frontal gyrus). It forms the dorsal stream of the perisylvian language network. Damage to the arcuate fasciculus disconnects these areas, resulting in conduction aphasia: the patient is fluent (Broca's intact), has good comprehension (Wernicke's intact), but has strikingly impaired repetition and frequent literal paraphasias. Transcortical aphasias spare repetition because the perisylvian core is intact while surrounding regions are damaged.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.