Alexia Without Agraphia: A Rare Entity

Abstract

Pure alexia refers to an acquired disorder associated with the damage to medial occipitotemporal gyrus in the dominant hemisphere, which is also known as visual word form area (VWFA). VWFA is involved in rapid word recognition and fluent reading. Alexia without agraphia is a disconnection syndrome that occurs when the splenium is also damaged with the occipital lobe on a dominant side.We report a case of a 72-year-old right-handed male who presented with alexia without agraphia accompanied by right homonymous hemianopia resulting from acute infarct of the left occipital lobe, the splenium of the corpus callosum and posterior thalamus that probably occurred on the previous day. During the evaluation, he exhibited marked impairment in the ability to read with the vision being grossly normal. Magnetic resonant imaging (MRI) revealed an acute infarct of the left occipital lobe, the splenium of the corpus callosum and posterior thalamus. A computerized tomography angiogram (CTA) revealed left posterior cerebral artery (PCA) territory infarct without any evidence of hemorrhagic conversion.Infarction of the occipital lobe on the dominant side (left) in a right-handed individual may cause a disruption in the visual word form area and is manifested by an inability to read with no abnormalities in visual acuity.

Neurorehabilitation of alexia without agraphia - a case report

“…Our results confirmed the clinical picture of alexia without agraphia which arises as a consequence of a lesion in medial occipitotemporal gyrus in dominant hemisphere [3], which is also known as an anatomic correlate for Visual Word Form Area (VWFA) [13]. This VWFA is included in the simultaneous recognition of complete words, and therefore also into the fluent, conventional reading.…”

“…Rehabilitacioni protokol se odnosi na trening tehnika taktilno-kinestetskog prepoznavanja grafema i primenu različitih tehnika čitanja, kao što su tehnika "slovo po slovo", tehnika višestrukog glasnog ponovljenog čitanja i melodijski intonirana tehnika glasnog čitanja sa ciljem restitucije stečenog poremećaja čitanja. Ključne reči: neurološka rehabilitacija; aleksija bez agrafije; korpus kalosum; poremećaji kognicije; moždani udar; hemianopsija; testovi mentalnog statusa i demencije the medial part of the occipital lobe and the splenium of corpus callosum, impairing activation of orthographic word representations [1][2][3]. Alexia without agraphia is an impairment of reading abil-ity with relatively preserved other linguistic functions: spontaneous speech, auditory comprehension, repetition and writing.…”

Unusual Presentation of a Posterior Cerebral Artery Stroke

“…3 The association with a contralateral visual field defect resulting in hemianopia, most often on the right, is due to damage to the left visual cortex. 3 Our patient presented with right superior quadrantanopia, which occurs when the calcarine artery (supplied by the superficial/distal PCA), is affected. 4 Clinically, assessing reading comprehension, writing ability, visual acuity, and visual fields are important to aid in diagnosis.…”

Cardiac Sarcoidosis as an Uncommon Etiology for Posterior Circulation Stroke Presenting with Alexia without Agraphia

“…Alexia without agraphia is a syndrome involving impaired communication between the inferior portion of the splenium of the corpus callosum and the medial occipitotemporal gyrus of the dominant hemisphere [5]. This condition leaves patients with preserved visual recognition and writing skills, but impaired ability to read due to a loss of visual input to the language area of the left angular gyrus [6].…”