In recnt years, the subtype or uniformity of conduction aphasia has been investigated by several authors. Among them, Lhermitte et al (1980) proposed that kinesthetic aphasia, as described by Luria, was distinguished by the clincal specificity and by the site of lesion in the anterior parietal region of the dominant hemisphere. We also had an opportunity to examine a patient (case 1 10)) developing conduction aphasia after cerebral infarction confined to the left anterior parietal region, and compared this case neurolinguistically with three other conduction aphasics (case 2, 3, 4) whose lesions were in other areas and with one Broca aphasic. The results of phonological analysis of speech sound errors (phonemic paraphasic errors), in case 1, were as follows : 1) Errors mainly occurred in consonants, unlike the three other conduction aphasics. This finding was rather similar to that of the Broca aphasic. 2) Concerning the erros types, substitution was seen more frequently than transposition, unlike the other conduction aphasics. This finding also resembled that of the Broca aphasic. However, in case 1, omission was less frequantly seen than in the Broca aphasic. 3) Errors, as with the other conduction aphasics, were distributed at random in terms of the distinctive feature distance, unlike in the Broca aphasic, more than half of whose errors were different from the target sounds only by one distinctive feature. These findings were close similar to those of Lhermitte et al. The above results suggest that the conduction aphasics with the anterior parietal lesion may be located in a particular position among conduction aphasics. Besides, we think that the impairment of speech output in case 1 without any comprehension disturbance is at a level closer to the phonetic level rather than to the phonemic level.
A case of constructional agraphia was reported for a 61-year-old, right-handed housewife. A lesion in the left parietal area was disclosed by CT scan. The patient presented an europsychological syndrome of Wernickes' aphasia with constructional apraxia. Her disturbance in oral language recovered considerably in about one year and turned to mild conduction aphasia. On the other hand, writing performance (copying, spontaneous writing and dictation) remained grossly disturbed. Moreover, she made mistakes in writing cubes. The writing disorders of the case at this stage were considered as constructional agraphia. Spontaneous writing tasks with ten nouns using kanji (ideograms) and hiragana (phonograms) were compared. The patient made a greater number of errors in kanji tasks than in hiragana. Error patterns in kanji were different from those in hiragana; the former showed errors of similar shapes to the target kanji, the latter comprised no responses or substitution of letters. Although she could not write spontaneously in kanji, she could explain each part of the target kanji word in oral language. This fact proves that the visual image of letters was preserved. The nature of the constructional agraphia in this case is discussed. The case was followed for four years, and disruption of writing performance still persists.
A 63-year old right-handed high school teacher of mathematics showed the syndrome of Gogi (word-meaning) aphasia (Imura, 1943) associated with intellectual impairment (presenile dementia). Generalized cortical atrophy was observed in CT-scans, in which atrophy was remarkable in the temporal lobes (especially left side). Neuropsychological features were as follows : (1) The subject displayed fluent spontaneous speech with difficulties in word finding. (2) Although he showed good oral repetition, he was severely impaired in verbal comprehension due to the difficulty in word-meaning comprehension. (3) He was impaired in reading and writing of Kanji characters selectively compared with Kana characters, such as on-kun confused paralexias and phonetically equivalent paragraphias in Kanji characters. (4) While he had no constructional problems, he had difficulties in the comprehension of general symbolic meanings and drawings. The syndrome of Gogi aphasia is also discussed comparing it with cases of Gogi aphasia and transcortical sensory aphasia previously reported.
The lateralized functional differentiation between the right and the left cerebral hemispheres is called cerebral lateralization. To date the language function has been supposed to be lateralized in the left hemisphere and the visuospatial function to be lateralized in the right in the typical differentiation for right-handed subjects. Since there has recently been an increasing number of reports on cases of imperfect lateralization from the viewpoint of the language function, we discussed this point in terms of the visuo-spatial function in 100 cases of putaminal hemorrhage (50 cases with right lesion, 50 with left). Unilateral spatial neglect (U. S. N.) was noted in 29 (58 %) out of 50 cases with the right-sided lesion, and it continued for more than 2 months in 18 of these cases (60 %). On the other hand U. S. N. was noted in 5 cases (10 %) out of 50 with the left lesion, but it disappeared in 3 of these cases within 1 month. These 5 cases were either left-handed, ambidextrous or had the familial disposition of left-handedness. The above results suggested the possibility of imperfect lateralization in the cases of U. S. N. with the left-sided lesion.