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Testing for the four features of Gerstmann Syndrome in this patient with two separate left sided strokes (left frontoparietal ischaemic stroke followed by left posterior parietal haemorrhagic stroke). He exhibits (i) acalculia, (ii) agraphia, (iii) left-right disorientation, and (iv) finger agnosia. Complicating the issue is his obvious nonfluent aphasia (expressive dysphasia) with paraphasic errors (replacing words with associated words (e.g. says 'fork' instead of 'spoon')) and some comprehension issues.

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People with serious comprehension difficulties have what is called Wernicke’s aphasia and: Often say many words that don’t make sense. May fail to realize they are saying the wrong words; for instance, they might call a fork a “gleeble.” May string together a series of meaningless words that sound like a sentence but don’t make sense. Have challenges because our dictionary of words is shelved in a similar region of the left hemisphere, near the area used for understanding words.

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