2014 Volume 36 Issue 2 Pages 76-81
A 67-year-old man presented with loss of vision on the left side due to a cerebral infarction caused by an anterior choroidal artery occlusion. The lesion was very small and confined to the right lateral geniculate body and its adjacent structures. A minute neurological and psychological examination performed at 22 months after the episode demonstrated left hemispatial agnosia, constructional disorder and agraphia, the last of which was more severe in Kanji than in Kana. Only a few case reports describe such unilateral spatial neglect due to a lesion mainly on the lateral geniculate body and having only one concomitant constructional disorder and agraphia. The lesions in those reports, however, included the thalamus or occipital lobe, being considerably larger than ours. The unilateral spatial neglect and constructional disorder are likely to have been caused by parietal lobe dysfunction. The agraphia in our case, being unaccompanied by aphasia, seems to be based on the constructional disorder. The blood flow reduction zone, in the SPECT image, extended from the right occipital lobe to a large part of the parietal lobe. It indicated the symptoms were presumably caused by a dysfunction of the right parietal lobe.
