Receptive, or Wernicke's aphasia, is distinguished by the inability to understand words or auditory signals, most commonly caused by cerebrovascular disorders, tumors or central nervous system infections. The diagnosis is made through a detailed patient interview and imaging studies.
Aphasia is most frequently encountered in middle-aged individuals and the elderly, as the most common causes are cerebrovascular insults and degenerative diseases (dementia), while central nervous system infections and neoplasms are other notable causes . The clinical presentation of patients with receptive (also known as fluent aphasia) is centered around the inability to comprehend words or any kind of auditory signal . This condition is also known as Wernicke's aphasia, named after Carl Wernicke who was the first person to recognize this disease. In this condition, both visual and tactile symbols may not be recognized . The term "fluent" aphasia describes the fluent and adequate speech seen in these patients, but with an uncharacteristic incorrect use of words in a nonsensical (known as paraphasia) or repetitive pattern   . It must be noted that patients are often unaware of the fact that their speech is without meaning . Moreover, inability to recall names of objects that are used on an everyday basis (anomia), as well as alexia and agraphia, defined as impaired ability to read and write words, respectively, are frequently encountered in patients suffering from receptive aphasia  . In some cases, visual deficits (primarily the right visual field) may be encountered due to the proximity of the left temporoparietal area to the visual pathway .
The diagnosis of receptive aphasia can be made through a simple verbal interaction with the patient (if he/she is conscious, as cerebrovascular insults can render patients unavailable for communication) . Bedside testing to detect specific subtypes of aphasia and exclude other conditions that share a similar clinical presentation, for eg. severe dysarthria, psychosis, delirium, and other acute psychiatric conditions, hearing loss, but also a foreign language background, is the mainstay during workup . Evaluation of spontaneous speech, writing and reading, naming of different objects, comprehension of spoken language, and word repetition may provide sufficient clues to confirm the diagnosis  . Cognitive testing may be a useful tool, while imaging studies - magnetic resonance imaging (MRI), magnetic resonance angiography, and even computed tomography (CT) can be of extreme importance in identifying the lesion responsible for the onset of symptoms, such as neoplastic tumors, abscesses or hemorrhage   . In virtually all patients, posterior superior and middle temporal gyri will be the site of damage .