Fluent aphasia in which language comprehension is severely impaired but repetition is relatively preserved. Speech is circumlocutory, often with semantic jargon. Fluent aphasia characterized by paraphasic speech (global paraphasias predominate over phonemic) and a severe impairment in aural comprehension. Yet repetition is intact (occasionally echolalic). This aphasia is similar to Wernicke’s aphasia except for the preserved repetition. Lesions have been reported to involve the posterior half of the brain from the occipitale pole forward on both the medial and lateral surfaces, often reaching along the medial occipital lobe in the area of distribution of the posterior cerebral artery.
Patients with transcortical sensory aphasia (TSA) have fluent and paraphasic speech (global paraphasias predominate over phonemic) and a severe impairment in aural comprehension. Yet their repetition is intact (occasionally echolalic), setting them clearly apart from Wernicke’s aphasics. The distinction is important since the localization of the lesion is different (see chapter 3 on localization). This underscores the need to test repetition in every aphasic patient.