A 62-year-old man with a left middle cerebral artery stroke speaks fluently in long sentences but uses incorrect words and cannot comprehend spoken or written language. Repetition is impaired. Which type of aphasia does he have, and where is the lesion?

• A Broca's aphasia, left inferior frontal gyrus
• B Conductive aphasia, arcuate fasciculus
• C Wernicke's aphasia, left posterior superior temporal gyrus ✓
• D Global aphasia, entire left perisylvian region

Explanation

Wernicke's aphasia features fluent but meaningless speech (paraphasias, neologisms), poor comprehension, and impaired repetition. The lesion is in Wernicke's area (posterior superior temporal gyrus of the dominant hemisphere, usually left). Broca's aphasia is non-fluent with preserved comprehension. Conductive aphasia features disproportionately impaired repetition with relatively preserved fluency and comprehension due to arcuate fasciculus damage.

Reference: Ganong's Review of Medical Physiology, 26th ed.

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