Main Article Content



1. This study was the first study identifying the characteristics of aphasia among ischemic stroke patients during COVID-19 pandemic at a national brain center in Indonesia.
2. This study provides additional data for future studies to conduct a comparison between the pre- and post-pandemic incidence of aphasia.



Different types of aphasia may occur due to lesions in various brain regions following ischemic strokes. Global aphasia was the most prevalent type of aphasia before the COVID-19 pandemic. However, stroke incidence and mortality rose during the pandemic. This study aimed to identify the types, clinical and radiological features, and management of aphasia in ischemic stroke cases during the pandemic. This study was a descriptive study with a cross-sectional design. The total sampling technique was used for the sampling process. The research samples were ischemic stroke subjects with aphasia who were diagnosed between January 1 and December 31, 2021, at the National Brain Center Prof. Dr. dr. Mahar Mardjono Hospital, Jakarta, Indonesia. The statistical analysis was performed using IBM SPSS Statistics for Mac, Version 25.0 (IBM Corp., Armonk, N.Y., USA). The results of this study showed that 162 aphasic subjects had suffered from ischemic strokes. The age range of the subjects was 34–87 years old. The majority of the subjects were male (59.9%) and aged 55–65 years (37.0%). The three most common risk factors were hypertension (90.1%), diabetes mellitus (50.0%), and dyslipidemia (75.9%). Motor aphasia (33.3%) and global aphasia (43.8%) were the most prevalent types of aphasia among the subjects. The parietal lobe was the main location of the causative lesions, as demonstrated by 38 global aphasic subjects and 47 motor aphasic subjects. The therapies administered to the subjects consisted of speech therapy (85.2%), antiplatelet therapy (98.1%), anticoagulants (19.1%), recombinant tissue plasminogen activator (rTPA) (1.2%), and neuroprotectors (3.0%). This study concluded that global aphasia was the most common type of aphasia among ischemic stroke patients during the pandemic, with the parietal lobe as the primary location of the causative lesions. 


Aphasia ischemic stroke health risk cardiovascular disease obesity

Article Details

How to Cite
Rasya Hapsari Danardhono, Arman Yurisaldi Saleh, Ria Maria Theresa, & Riezky Valentina Astari. (2023). Characteristics of Aphasia in Ischemic Stroke Patients at a National Brain Center in Indonesia. Folia Medica Indonesiana, 59(4), 341–349.


  1. Ardila, A. (2018) ‘Participation of the insula in language’, Island of Reil (Insula) in the Human Brain: Anatomical,
  2. Functional, Clinical and Surgical Aspects, pp. 123–128. doi: 10.1007/978-3-319-75468-0_12.
  3. Bohra, V. et al. (2015) ‘Clinicoanatomical correlation in stroke related aphasia’, Annals of Indian Academy of
  4. Neurology, 18(4), pp. 424–429. doi: 10.4103/0972-2327.165469.
  5. Bushnell, C. D. et al. (2018) ‘Sex differences in stroke: Challenges and opportunities’, Journal of Cerebral
  6. Blood Flow and Metabolism, 38(12), pp. 2179–2191. doi: with 10.1177/0271678X18793324.
  7. Couto, P. B., Neves, V. de C. R. and Barreto, S. dos S. (2020) ‘Aphasia rate and user profile in a public referral
  8. hospital Frequência de afasia e perfil de usuários em hospital público municipal de referência’, Scielo Brazil,
  9. pp. 1–7. Available at:
  10. David Spence, J., et al. (2020) ‘Mechanisms of Stroke in COVID-19’ Cerebrovascular Diseases, 49(4), pp. 451–458. doi: 10.1159/000509581.
  11. Døli, H. et al. (2021) ‘Associations between lesion size, lesion location and aphasia in acute stroke’, Aphasiology, 35(6), pp. 745–763. doi: 10.1080/02687038.2020.1727838.
  12. Duron, L. et al. (2021) ‘Imaging of Vascular Aphasia’, Intech, pp. 225–240. Available at:, V. L.,
  13. Norrving, B. and Mensah, G. A. (2017) ‘Global Burden of Stroke’, Circulation Research, 120(3), pp. 439–448. doi:
  14. 1161/CIRCRESAHA.116.308413.
  15. Fitri, F. I. and Lastri, D. N. (2019) ‘Gambaran sindrom afasia kronik dan perubahannya pasca terapi’, The
  16. Journal of Medical School, 3(1), pp. 125–132. Available at:
  17. Flowers, H. L. I. (2016) ‘The Incidence, Co-occurrence, and Predictors of Dysphagia, Dysarthria, and Aphasia
  18. after Acute Ischemic Stroke’. Available at:
  19. Froio, N. L. et al. (2017) ‘Anticoagulation in acute ischemic stroke: A systematic search’, Revista da Associacao Medica Brasileira, 63(1), pp. 50–56. doi: 10.1590/1806-9282.63.01.50.
  20. Giulio, P. (2020) ‘Aphasia: Definition, clinical contexts, neurobiological profiles and clinical treatments’, Annals
  21. of Alzheimer’s and Dementia Care, 4, pp. 021–026. doi: 10.17352/aadc.000014.
  22. Grönberg, A. et al. (2022) ‘Incidence of Aphasia in Ischemic Stroke’, Neuroepidemiology, 56(3), pp. 174–182. doi: 10.1159/000524206.
  23. Hasanah, N. El (2017) ‘Insidensi afasia pada pasien stroke akut yang dirawat inap di rsu haji medan pada bulan
  24. september-desember tahun 2016’. Indonesia, K. K. R. (2019) ‘KEPUTUSAN MENTERI KESEHATAN REPUBLIK INDONESIA NOMOR HK.01.07/MENKES/394/2019 TENTANG PEDOMAN NASIONAL PELA Y ANAN
  25. KEDOKTERAN TATA LAKSANA STROKE’, pp. 1–19. Available at:
  26. &partnerID=tZOtx3y1%0A
  27. Jianu, D. C. et al. (2021) ‘A Comprehensive Overview of Broca’s Aphasia after Ischemic Stroke’, Intech, pp. 225–
  28. Available at:
  29. Cătălin Jianu D, Nina Jianu S, Petrica L, et al. (2021). ‘Vascular Aphasias’. Ischemic Stroke. IntechOpen.
  30. Available at:
  31. Kang, E. K. et al. (2017) ‘Subcortical aphasia after stroke’, Annals of Rehabilitation Medicine, 41(5), pp. 725–733. doi: 10.5535/arm.2017.41.5.725.
  32. Kasselimis, D. et al. (2011) ‘Transcortical sensory aphasia after extensive left perisylvian lesion: A case of mixed
  33. dominance’, Procedia - Social and Behavioral Sciences, 23(October), pp. 236–237. doi: 10.1016/j.sbspro.2011.09.256.
  35. Kementrian Kesehatan (2014) Profil Kesehatan Indonesia Tahun 2013, Jakarta: Kementerian Kesehatan RI. doi: 351.770.212 Ind P.
  36. Kesehatan, K. (2013) ‘Laporan Nasional Riskesdas’, Badan Penelitian dan Pengembangan Kesehatan, 127(3309), pp. 1275–1279. doi: 10.1126/science.127.3309.1275.
  37. Khedr, E. M. et al. (2021) ‘Post-stroke dysphagia: frequency, risk factors, and topographic representation: hospital-based study’, Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 57(1), pp. 1–7. doi: 10.1186/s41983-021-00281-9.
  38. Kleindorfer, D. O. et al. (2021) 2021 Guideline for the prevention of stroke in patients with stroke and transient
  39. ischemic attack; A guideline from the American Heart Association/American Stroke Association, Stroke. doi:
  40. 1161/STR.0000000000000375.
  41. Krishna Karthik, D. et al. (2017) ‘Global aphasia in a case of bilateral frontal lobe infarcts involving both caudate nuclei’, BMJ Case Reports, 2017, pp. 1–2. doi: 10.1136/bcr-2017-221642.
  42. Lan, R. et al. (2020) ‘Bilateral corpus callosum and corona radiata infarction due to cerebral venous sinus thrombosis presenting as headache and acute reversible aphasia: A rare case report’, BMC Neurology, 20(1), pp. 1–5. doi: 10.1186/s12883-020-01829-7.
  43. Laporan Nasional Riskesdas (2018) ‘Laporan Nasional RISKESDAS 2018’, Badan Penelitian dan Pengembangan Kesehatan, p. 198. Available at:
  44. Lee, R. H. C. et al. (2018) ‘Cerebral ischemia and neuroregeneration’, Neural Regeneration Research, 13(3), pp. 373–385. doi: 10.4103/1673-5374.228711.
  45. Li, Tianyi et al. (2021) ‘Childhood ischaemic stroke in the basal ganglia can lead to fine motor and anxiety disorders: a retrospective analysis and follow-up of 109 cases’, BMC Neurology, 21(1), pp. 1–9. doi: 10.1186/s12883-021- 02112-z.
  46. Lorca-puls, D. L. et al. (2021) ‘Brain regions that support accurate speech production after damage to Broca ’ s area’, pp. 1–19. doi: 10.1093/braincomms/fcab230.
  47. Mitchell, A. B. et al. (2015) ‘Obesity Increases Risk of Ischemic Stroke in Young Adults’, Stroke, 46(6), pp. 1690–1692. doi: 10.1161/STROKEAHA.115.008940.
  48. Mitchell, C. et al. (2021) ‘Prevalence of aphasia and dysarthria among inpatient stroke survivors: describing the population, therapy provision and outcomes on discharge’, Aphasiology, 35(7), pp. 950–960. doi: 10.1080/02687038.2020.1759772.
  49. Mubasher, S. S., et al. (2021). ‘Prevalence, Risk Factors, and Management of Stroke in Patients with COVID-19 Infection: A Review’, Journal of Advances in Medical and Pharmaceutical Sciences. pp. 10–17. doi: 10.9734/jamps/2021/v23i730245.
  50. Nabila, S. N. (2020) ‘Perbedaan Status Gizi Pasien Stroke Iskemik dan Stroke Hemoragik di RSUP Fatmawati Tahun 2018’, Seminar Nasional Kedokteran, pp. 86–92.
  51. Othadinar, K., Alfarabi, M. and Maharani, V. (2019) ‘Faktor Risiko Pasien Stroke Iskemik dan Hemoragik’, Majalah Kedokteran UKI, 35(3), pp. 115–120.
  52. Pan, B. et al. (2019) ‘The relationship between smoking and stroke A meta-analysis’, Medicine (United States), 98(12), pp. 1–8. doi: 10.1097/MD.0000000000014872.
  53. Rangus, I. et al. (2022) ‘Frequency and phenotype of thalamic aphasia’, Journal of Neurology, 269(1), pp. 368–376. doi: 10.1007/s00415-021-10640-4.
  54. Rasyid, A. et al. (2019) ‘Blood Viscosity As a Determining Factor of Ischemic Stroke Outcomes Evaluated With Nihss and Mrs on Day 7 and 30 Post- Thrombolysis’, International Journal of Pharmacy and Pharmaceutical Sciences, 11(9), pp. 73–79. doi: 10.22159/ijpps.2019v11i9.34820.
  55. Silva, B. N. et al. (2020) ‘Development of computer- aided semi-automatic diagnosis system for chronic post-stroke aphasia classification with temporal and parietal lesions: A pilot study’, Applied Sciences (Switzerland), 10(8). doi: 10.3390/APP10082984.
  56. Silveri, M. C. (2021) ‘Contribution of the Cerebellum and the Basal Ganglia to Language Production: Speech, Word Fluency, and Sentence Construction—Evidence from Pathology’, Cerebellum, 20(2), pp. 282–294. doi: 10.1007/s12311-020-01207-6.
  57. Sofyan, A. M., Sihombing, I. Y. and Hamra, Y. (2015) ‘Hubungan Umur, Jenis Kelamin dan Hipertensi dengan Kejadian Stroke’, Jurnal Medula, 1(1), pp. 24– 30.
  58. Thambas, A. T., Lalenoh, D. C. and Kambey, B. I. (2021) ‘Gambaran Pasien Stroke Iskemik Akut dengan COVID-19 yang Masuk Ruang Perawatan Intensif’, eCliniC, 9(1), pp. 161–166. doi: 10.35790/ecl.v9i1.32302.
  59. Utomo, T. Y. (2022) ‘HUBUNGAN FAKTOR RISKO TERHADAP KEJADIAN STROKE PADA PENDERITA CORONA VIRUS DISEASES-2019’, Jurnal Ilmiah Indonesia, 7(8.5.2017), pp. 2003–2005.
  60. Walenski, M. et al. (2022) ‘Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions’, Neurobiology of Language, 3(2), pp. 345–363. doi: 10.1162/nol_a_00068.
  61. Wang, Y. et al. (2021). ‘Diagnosis and differential diagnosis flow diagram of Chinese post-stroke aphasia types and treatment of post-stroke aphasia’. Aging Medicine. doi: 10.1002/agm2.12183

Most read articles by the same author(s)