Crossed aphasia with left spatial neglect and visual imperception: a case report |
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Authors: | B Paghera P Mariën LA Vignolo |
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Institution: | (1) Neurological Clinic, University of Brescia, Spedali Civili, I-25125 Brescia, Italy, IT;(2) Department of Neurology, General Hospital Middelheim, Antwerp, Belgium, BE |
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Abstract: | A 64-year-old right-handed woman with no left-handers in the family developed aphasia associated with moderate left hemiparesis
and dense left homonymous hemianopia following rupture of a right middle cerebral artery aneurysm and subsequent selective
surgery confined to the right hemisphere. Severe left spatial neglect and constructional apraxia were also present. The patient
was an achondroplasic dwarf whose previous medical and neurological history was otherwise unremarkable. Computed tomography
of the brain showed a large right temporo-insulofrontoparietal lesion. Language and nonverbal cognitive functions were assessed
after 2 and 6 months, and then four years later. A reportedly overall language disruption in the acute period evolved into
Wernicke's aphasia and then into a mild form of conduction aphasia. The associated left spatial neglect eventually shrank
to a minimum. The patient never had clinically detectable visual agnosia, but on specific tests of visual recognition and
perception some impairment was found four years after onset. The left hemiparesis disappeared in time while the left hemianopia
persisted. This case is a convincing example of an entirely righthanded person in whom both linguistic and visuospatial functions
are represented in the right hemisphere.
Received: 12 May 2002 / Accepted in revised form: 18 November 2002
Correspondence to L.A. Vignolo |
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Keywords: | Crossed aphasia Visual spatial disorders Language |
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