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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of alexia without agraphia, one due to a cerebrovascular accident which improved spontaneously and the other in a cerebral abscess partially recovered after surgical treatment are presented. Both were anatomically verified by computed tomography. The second was also verified at surgery. A small well localized lesion of the fusiform and lingual gyri in the dominant hemisphere can lead to alexia without agraphia. The lack of involvement of the optic radiation and calcarine fissure explain the abscence of visual field defects and hence the purest type of this syndrome as shown in our first case. The involvement of the splenium of the corpus calosus and related forceps majors seems essential for a long lasting reading defect. The integrity of the dorsal or superior splenium is responsible for the abscence of the color warning defect found on about 30% of the cases of pure word blindness. The severity and ultimate progression of the alexia will depend not only upon the extension of the dominant occipital lesion but of its association with the damage of other possible pathways. A slowly growing and potentially treatable expanding lesion, as in our second case, can also produce an almost pure form of the syndrome. It appears to us that the wider use of CT will allow on the near future will lead to a better knowledge of the anatomical lesions and a better understanding of this fascinating syndrome.
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PMID:[Alexia without agraphia (clinicotomographic correlation)]. 58 31

A 78 year old, right handed man developed the syndrome of alexia without agraphia due to a right occipital thrombotic stroke. The cerebral dominance test strongly suggests that his right hemisphere is dominant. This is believed to be the first case of alexia without agraphia secondary to a right occipital lesion in a right handed person.
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PMID:Alexia without agraphia associated with right occipital lesion. 88 49

A case of stroke with amnesia, hemianopsia, alexia without agraphia, colour anomia is reported. CT of the brain demonstrated presence of an ischaemic focus in the temporo-parieto-occipital area. Hemianopsia and colour anomia persisted longer than other symptoms.
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PMID:[Full-symptom ischemic stroke in the area of the left posterior cerebral artery]. 152 72

A 54-year-old non-right-handed man with positive familial sinistrality showed a pure right hemisphere syndrome following a left hemisphere stroke. Severe right side hemineglect, transcortical motor dysprosodia, spatial dysgraphia and visuo-constructive impairments were observed. At no time were the expected left hemisphere abnormalities such as aphasia, alexia, right-left disorientation or finger agnosia noted. A left fronto-temporal subcortical lesion was documented on CT scan. A Tc-99m HM-PAO SPECT study revealed no cerebral blood flow changes in the right hemisphere while in the left hemisphere a fronto-temporo-parietal cerebral blood flow reduction was evident. This case of a complete reversed laterality of cognitive functions argues for a distinction to be made between 'anomalous' cerebral dominance and 'atypical' cerebral dominance.
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PMID:Reversed laterality of cerebral functions in a non-right-hander: neuropsychological and spect findings in a case of 'atypical' dominance. 173 72

Aphasia therapy in adults has been established to a larger extent relatively lately in the history of aphasiology, i.e. after its social medical importance had been realized and one of the cardinal problems of neurology solved more satisfactorily--lesion localization by imaging techniques. In order to evaluate the efficiency of aphasia therapy--which is still not quite uncontradicted--it was necessary to acquire sufficient knowledge of the spontaneous recovery process. It takes place--e.g. after stroke--mainly during the first 3 months, coming, as a rule, to a halt during the first year. Longer recovery periods, however, have been described. Next to etiology neurological status, overall health condition, type and severity of aphasia, and time delay between onset of the disease and start of therapy have been ascertained, whereas age and handedness seem to be of minor relevance. If syndrome change occurs the boundary between Broca's and Wernicke's aphasia is not surpassed; this taken apart almost any change from a more severe to a milder form of aphasia is possible. To isolate the therapeutic effect from spontaneous recovery in larger groups is difficult. There are, however, more recent investigations which suggest, that a correctly indicated therapy, which is sufficiently intensive and lasts long enough, will be effective. One of the corner-stones of any therapeutic effort ist adequate stimulation, oriented toward the patients needs and his aphasic syndrome, and taking into account the systemic nature of language and its most important linguistic structural components. Furthermore, a phase-specific and interdisciplinary approach and integration of closely related persons play an important role. We divide the numerous therapeutic techniques into 3 groups: direct or stimulation approach, indirect or circumventory approach, compensatory or alternative strategies approach. Representatives of all 3 groups are presented briefly, e.g. auditory stimulation, divergent semantic intervention, promoting aphasics communicative effectiveness, language enrichment therapy, programmed instruction; then the deblocking method, melodic intonation therapy, imagery, a sample of linguistically oriented methods for the reeducation of syntax, semantics, and phonemics along with special methods for the treatment of alexia and agraphia; finally compensatory techniques like visual communication, visual action therapy, and bliss symbolics. Some particular problems encountered in working with aphasics are addressed. A point is made about the feasibility and profit of lay therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Current status of aphasia therapy]. 242 25

A 77 year old right handed male was blind since the age of 2. He presented with an infarction involving the territory of the left middle cerebral artery involving the temporal and the inferior parietal lobes. He had learned to read and write language as well as read and write music in braille, ultimately becoming a famous organist and composer. There were no motor or sensory deficits. Wernicke's aphasia with jargonaphasia, major difficulty in repetition, anomia and a significant comprehension deficit without word deafness was present; verbal alexia and agraphia in braille were also present. There was no evidence of amusia. He could execute in an exemplary fashion pieces of music for the organ in his repertory as well as improvise. All his musical capabilities: transposition, modulation, harmony, rythm, were preserved. The musical notation in braille remained intact: he could read by touch and play unfamiliar scores, he could also read and sing the musical notes, he could copy and write a score. Nine months after the stroke his aphasia remained unchanged. Nevertheless he composed pieces for the organ which were published. Such data highly suggest the independence of linguistic and musical competences, defined as the analysis and organization of sounds according to the rules of music. This independence in an extremely talented musician leads to a discussion of the role of the right hemisphere in the anatomical-functional processes at the origin of musical competence. The use of braille in which the same constellations of dots correspond either to letters of the alphabet or musical notes supports the independence between language and music.
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PMID:[Aphasia without amusia in a blind organist. Verbal alexia-agraphia without musical alexia-agraphia in braille]. 361 63

A 59-year-old, right-handed, college-educated male examined after stroke presented spelling alexia with relative sparing of writing. He was not aphasic. A striking feature of the alexia was preserved recognition of letters printed in view by the clinician. He was able to read words through letter-by-letter oral spelling when letters were presented in this dynamic fashion. We describe this as a dynamic form of spelling alexia. Head CT scan showed a large left hemisphere posterior lesion infringing on the corpus callosum, and a right hemisphere opercular lesion. We suggest that sparing of the right parietal-occipital cortex may contribute to the remarkable sparing of dynamic letter reading.
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PMID:Dynamic spelling alexia. 370 57

A 39-year-old male developed a right homonymous hemianopsia and alexia without agraphia following emergency surgery for hemorrhage into a left frontal tumor. A computerized tomographic (CT) scan demonstrated low density areas in the left frontal region and in the territory of the left posterior cerebral artery. The alexia without agraphia syndrome appeared to result from compression of the left posterior cerebral artery by a transtentorial pressure cone, a mechanism not previously reported in this syndrome. The behavioral investigation confirmed the diagnosis and replicated recent findings related to the syndrome of alexia without agraphia.
Stroke
PMID:Transtentorial herniation with posterior cerebral artery territory infarction. A new mechanism of the syndrome of alexia without agraphia. 706 96

Anatomical and physiological investigations indicate two major distinct functional streams within the extrastriate visual cortex of the macaque monkey, and behavioral observations suggest that the ventral (occipitotemporal) pathway is the cornerstone for object recognition whereas the dorsal (occipitoparietal) pathway is primarily involved in visuospatial perception and visuomotor performance. In the context of this dichotomy we conducted a psychophysical and neuropsychological study of visual perceptual abilities in two stroke patients, each with lesions involving several extrastriate areas. Magnetic resonance imaging demonstrated bilateral lesions; in one patient (E.W.) the lesion involves the ventral medial portions of the occipital and temporal lobes, and in the other (A.F.) the lesion involves dorsally the occipital-parietal area, including the region of the temporal-parietal-occipital junction. E.W. suffers from achromatopsia of central origin, prosopagnosia, visual agnosia, and alexia without agraphia. His depth and motion perception, including recognition of moving objects, are normal. He has superior visual field loss bilaterally, and slightly impaired acuity, and complains that the world appears in a deep twilight even on a sunny day. In contrast, A.F. shows specific deficits of stereopsis, spatial localization, and several aspects of motion perception. He is also impaired at recognizing objects presented from unconventional views, but recognition of prototypical views of objects, and color and form discrimination are normal, as is his ability to recognize faces. The anatomical characteristics of the lesions of these two patients permit a direct experimental comparison of the effects of lesions confined to the parietal or temporal pathways. E.W.'s and A.F.'s performance on the psychophysical and neuropsychological tasks discussed here supports the functional distinction between a dorsal and a ventral extrastriate system but additionally suggests the existence of a pathway involved in identification-from-motion that is separate from both the dorsal early motion/spatial analysis pathway and the ventral color/static-form pathway.
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PMID:Functional segregation of color and motion processing in the human visual cortex: clinical evidence. 783 56

Of 598 consecutive non-selected cases of cerebral infarction included in a stroke registry, 82 cases (54 men and 28 women, mean age 66 +/- 14 years) of spontaneous and isolated posterior cerebral artery (PCA) territory infarction (right PCA in 36, left PCA in 35 and both in 11) were identified on the basis of CT combined with MRI in 51 cases. Infarction was superficial in 25 (group A), combined deep-superficial in 23 (group B) and deep in 34 (group C). Of 48 superficial lesions, 29 were massive while 19 were restricted to the territory of one branch. Of 57 deep lesions, 21 were located in the inferolateral thalamic territory, 10 in the paramedian thalamic territory, 12 in other midbrain or thalamic territories, and 14 in a combination of various midbrain and/or thalamic territories. Of 41 patients with unilateral superficial involvement, 39 had homonymous visual field defect. Unawareness of the visual defect and visual release hallucinations were observed with the same frequency in right and left lesions. Of 7 patients with bilateral superficial involvement, only 5 had bilateral visual field defect including incomplete cortical blindness in 3. The frequency of confusional state (n = 24) did not differ significantly in left versus right sided lesions while it was significantly higher in superficial or combined versus deep lesions (p = 0.05). Of 18 clinically evaluable patients with left PCA territory infarct, 14 had speech disorders including pure alexia in only one case. Of 15 patients with right territory infarction, 10 had spatial judgement disorders.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A study of 82 cerebral infarctions in the area of posterior cerebral arteries]. 779 86


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