Abstract
We reported on a patient who developed alexia with agraphia associated with left posterior cerebral artery occlusion. The subject was a 53-year-old right handed male. Neuropsychologically, alexia with agraphia and color agnosia were observed. Reading disturbance was moderate, and motor facilitation had almost no effect. Writing disturbance was severe. Spontaneous writing, dictation and letter copying were disturbed, although letter copying was relatively unimpaired.
One and a half months after onset, alexia and disturbance in letter copying improued but agraphia and color anomia did not. During the clinical course, cerebral angiography revealed occlusion in the left posterior cerebral artery, while CT scan showed only small infarctions in the left thalamus and bilateral corona radiata. 54 days after onset, hemorrhagic shock developed, and subsequently a new infarction appeared from the medial aspect of the occipital lobe to the temporal lobe. However, neuropsychologically no marked changes were observed. Agraphia and color anomia remained and have continued for 3 years.
Findings indicate that the patient developed alexia with agraphia associated with damage to the basin of the left posterior cerebral artery, especially the left temporal lobe. However, evaluation of changes in the neuropsychological findings suggests that different mechanisms are involved in the development of alexia and agraphia.
