2019 Volume 39 Issue 2 Pages 237-242
A 57-year-old right-handed man had left hemispatial neglect, constructive disturbance, and dressing apraxia 4 weeks after the onset of right parieto-occipital subcortical hemorrhage. His brother had a history of correcting his left-handedness. The patient had normal ability in verbal comprehension, verbal expression, and reading, but had difficulty in Kanji writing. His errors in the task of writing Kanji letters included no response, partial response, and non-existing letters similar to an actual Kanji, which suggested pure agraphia. In addition to those, his errors also included poor spatial arrangement in the whole components of a Kanji letter, which indicated constructional agraphia. In the task of dictating and copying 51 Kanji letters that were randomly chosen from those taught in the 1st, 2nd, and 3rd grades of Japanese elementary school, the responses consistent to pure agraphia were decreased markedly in copying, but the frequencies of the responses corresponding with constructional agraphia were similar between dictation and copying. In his constructional agraphia, some letters had a disarranged placement of larger parts of a Kanji letter (Bushu［radicals］of a Kanji) , and some letters had a disarranged placement of major components within a radical. Some authors recently reported patients with constructional agraphia after right hemisphere damage. Constructional agraphia may be caused by lesion in the right hemisphere with an atypical lateralization, as well as left parietal lesion.
