Neurobehavioural deficits following right cerebral infarction

Abstract

Language dysfunction following infarction in the right posterior cerebral artery territory is uncommon in a right-hander. The area of damage had been well identified on the MR scan. The patient was studied from the neurological and neuropsychological points of view. The patient had a mixed transcortical aphasia (thalamic), apraxic disturbances, possible Gerstmann's syndrome and autotopagnasia, cerebral functions strongly lateralized to the left hemisphere. He had no impairment of affective prosody and had no neglect usually associated with right hemispheric damage. He may thus, in fact, have had a true transverse hemisphere rather than primarily a crossed aphasia. He also exhibited other deficits, namely, severe alexia, colour anomia and left hemianopia. Neuroimaging with CT scan, MRI and the EEG demonstrated no abnormality in the left hemisphere. The clinico-anatomical correlations are discussed. The report illustrates the variety of language and behavioural disorders that can occur, and the complexities of lateralization.