A patient who has language difficulty after a brain injury most likely has language impairment if the patient is status post which type of stroke?

• A. 63-year-old female status post right CVA
• B. 41-year-old female diagnosed with Guillain-Barre syndrome
• C. 32-year-old male with a traumatic brain injury presently classified as confused-appropriate
• D. 52-year-old male status post left CVA

Answer: (D)

Language skills are predominantly controlled by the dominant hemisphere, which in most right-handed people is the left side of the brain. A stroke affecting the left hemisphere disrupts the language centers (like Broca’s and Wernicke’s areas), leading to aphasia or other language impairments. This is why a left-hemisphere stroke is most likely to cause language difficulties after brain injury.

A stroke on the right side of the brain typically yields problems with visual-spatial processing and neglect, not core language deficits. Guillain-Barre syndrome is a peripheral nerve condition and does not directly cause cortical language impairment. A traumatic brain injury described as confused-appropriate reflects generalized cognitive impairment rather than a specific stroke-related language deficit, and the question focuses on stroke-type–related language impact.