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.
Highlights
Alexia without agraphia or pure alexia is an acquired disorder secondary to a defect in the left occipitotemporal region affecting the visual word form area (VWFA)
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
A magnetic resonance imaging of the brain performed on the prior day had revealed an acute infarction of the left occipital lobe extending into the splenium of the corpus callosum and posterior thalamus
Summary
Alexia without agraphia or pure alexia is an acquired disorder secondary to a defect in the left occipitotemporal region affecting the visual word form area (VWFA) In this condition, most of the patients have right-sided homonymous hemianopia due to the involvement of the occipital lobe [1]. A magnetic resonance imaging of the brain performed on the prior day had revealed an acute infarction of the left occipital lobe extending into the splenium of the corpus callosum and posterior thalamus. The cerebral angiogram revealed an acute infarct in the territory of the left posterior cerebral artery and an incidental finding of high grade left internal carotid artery stenosis He was admitted into neurology inpatient service to find out the cause of the stroke and for treatment by standard stroke protocol. The patient was discharged and put on telemetry for continuous monitoring of any paroxysms of atrial fibrillation
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