Alexia Without Agraphia in a Right-Handed Individual Following Right Occipital Stroke

Abstract

Alexia without agraphia is a disconnection syndrome that typically involves damage to the occipital lobe, with splenium involvement, in the dominant left hemisphere. We describe an exceptionally rare case of a right-handed individual displaying this deficit following a right-sided occipital stroke. A report of a single case of a 65-year-old man is presented with data from appointments with the neurology and neuropsychology departments that occurred approximately 10 and 12 months following the patient's stroke. During the evaluation, he exhibited a marked deficit in his ability to read, with vision grossly intact. His ability to write single words and short phrases from dictation was intact, but he was later unable to read them. This case demonstrates the complexity of the organization of language in the human brain. Although a large majority of individuals exhibit language dominance in their left hemispheres, it remains possible that some right-handed individuals may show atypical organization of language. This highlights the need for clinicians to consider atypical cortical organization when observed deficits may not necessarily match expected lesions within the cortex.

Key words:

• alexia
• assessment/diagnosis
• cerebral stroke
• cognition
• magnetic resonance imaging
• neuropsychology

ACKNOWLEDGMENTS

This material is the result of work supported with resources and the use of facilities at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, TX. We would also like to acknowledge Drs. Joseph Kass and Arjun Tarakad for their care in the treatment of this patient.