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At least 487 records · Page 27Linked to original sources
PubMedDate not supplied

Treatability of different components of aphasia - insights from a case study.

In this phase I clinical rehabilitation study, we investigated the effects of phonological rehabilitation for alexia and aphasia in an individual 54 years after a left-hemisphere ischemic infarction. In the context of a single-subject design, we studied whether treatment would improve phonological processing, reading, and generalization to untreated behaviors. While results showed a lack of generalization to real-word reading aloud, improvement was present in phonological processing, language function (Western Aphasia Battery Aphasia Quotient, Boston Naming Test, Reading Comprehension Battery for Aphasia), and auditory processing (Revised Token Test). Improvement in the lexical-semantic system was attributed to informal forced-use language treatment. We concluded that phonological therapies are unlikely to be successful unless a minimum initial level of phonological sequence knowledge exists; therapies that pressure subjects to use verbal communication can achieve clinically important gains in communicative ability that generalize to untreated behaviors. This study also demonstrates the importance of a careful analysis of the patient's language ability before a therapeutic strategy is chosen.

Aged↗
PubMed2006

Safe removal of glioblastoma near the angular gyrus by awake surgery preserving calculation ability--case report.

A 67-year-old patient presented with progressive agraphia, alexia, and impaired ability to calculate persisting for 4 weeks. He showed preserved ability to do single-digit addition and subtraction. Magnetic resonance imaging demonstrated a tumor in the left parietal lobe. A malignant glioma was suspected, and awake craniotomy was performed to remove the tumor with functional cortical mapping to determine the cortices involved in calculation and language. His calculation ability was mapped on the angular gyrus, and partial resection of the tumor was achieved without deterioration of that ability. The histological diagnosis was glioblastoma multiforme. The patient's calculation ability improved dramatically after the operation.

Aged↗
PubMed1994

Spatial acalculia.

Twenty-one patients with right hemisphere damage were studied (11 men, 10 women; average age = 41.33; range 19-65). Patients were divided into two groups: pre-Rolandic (six patients) and retro-Rolandic (15 patients) right hemisphere damage. A special calculation test was given. Different types of calculation errors were analyzed. Spatial alexia and agraphia for numbers, loss of calculation automatisms, reasoning errors, and general spatial defects interfering with normal number writing and reading, were observed. Number processing was impaired, whereas the calculation system was partially preserved. Fact retrieval and procedural difficulties were observed, but arithmetical rules were properly used. It is concluded that calculation abilities in right hemisphere damaged patients are disrupted as a result of: (1) visuospatial defects that interfere with the spatial arrangement of numbers and the mechanical aspects of mathematical operations: (2) inability to recall mathematical facts and appropriately to use them; and (3) inability to normally conceptualize quantities and process numbers.

Adult↗
PubMed1996

Balint's syndrome arising from bilateral posterior cortical atrophy or infarction: rehabilitation strategies and their limitation.

Balint's syndrome is characterized by faulty visual scanning, dysmetria secondary to a visual perceptual deficit, and an inability to recognize more than one object at a time. We report three cases of Balint's syndrome and the individualized rehabilitation they received. One patient developed symptoms of Balint's syndrome caused by bilateral occipitoparietal infarcts. In the two other cases the symptoms arose secondary to posterior cortical atrophy, a slowly progressive dementia with alexia and agraphia. All three patients initially responded to a multicontext treatment approach with intensive verbal cueing and organizational strategies with subsequent improvement in visual recognition, reaching and scanning. Continued deterioration from posterior cortical atrophy or a second infarction resulted in worsening dementia in two patients. Cognitive remediation was required as visual perceptual rehabilitation became ineffective. Clinicians should be familiar with Balint's syndrome and its various aetiologies. Lack of awareness of this syndrome may lead to a misdiagnosis and resulting inappropriate or inadequate treatment.

Agnosia↗
PubMed1999

[Cerebral metastasis from a renal cell carcinoma more than 10 years after nephrectomy: report of two cases].

The authors report two cases with renal cell carcinoma (RCC) metastatic to the brain more than 10 years after nephrectomy. Case 1: An eighty-six-year-old female, on whom nephrectomy had been performed 12 years before, complained of alexia. Computed tomography (CT) revealed ring enhancement in the left temporoparietal region. Total removal of the brain tumor and irradiation of 18 Gy during surgery was performed. Histological examination showed metastatic brain tumor from RCC. The postoperative course was excellent. In the postoperative examination lung metastasis was found. Case 2: A sixty-seven-year-old male, on whom nephrectomy had been performed 15 years before, presented with right hemiparesis, aphasia and convulsion. CT showed two enhanced lesions, one of which accompanied with a hematoma in the left frontal lobe. Chest X-ray showed a coin lesion in the right lower lobe. Total removal of brain tumors was performed and 18 Gy irradiation was administered during surgery. Histological study revealed RCC. However, 3 months after surgery, a new lesion was recognized in the opposite hemisphere. The long interval of latency may be attributed to the slow-growing characteristic of renal cell carcinoma and the fact that renal cell carcinoma is under the influence of host immunity. Surgical treatment is recommended for patients who develop a solitary metastatic lesion or in whom other lesions are controlled and remain in a stable condition.

Aged↗
PubMedDate not supplied

[Acalculia. Neurological bases, evaluation and disorders].

OBJECTIVE: To make a review of the literature on alterations in mathematical ability secondary to structural cerebral lesions. DEVELOPMENT AND CONCLUSIONS: We refer to the initial classification of acalculia of Berger (secondary acalculia when this is due to broader neuropsychological deficits and primary acalculia when it occurs alone) to the classical division of Hecaen (alexia and numerical agraphia with or without alterations in reading and writing of letters and words, visuo-spatial acalculia due to alterations in the spatial organization of multi-digit figures and the partial results of arithmetical operations, anarithmetia or primary failure in mathematical ability) and the most recent classifications based on neurocognitive models, which subdivide the acalculias into those secondary to changes in the system for processing numbers and those due to changes in the cognitive system for mathematics (McCloskey and Caramazza). Similarly, we review the correlations between the clinical changes in mathematics and the cerebral localization of the causative lesions (left parieto-temporal, right and including frontal and subcortical associative areas) together with the association of acalculia and other neuropsychological deficits. Finally we review the neuropsychological instruments available for the evaluation of acalculias, with particular reference to the tools validated and scaled for our language and sociocultural setting.

Agraphia↗
PubMed2000

Eye movement abnormalities during reading in patients with Alzheimer disease.

OBJECTIVE: This goal of this study was to evaluate reading ability by assessing eye movements during reading among patients with Alzheimer disease (AD) compared with normal elderly controls. BACKGROUND: Reading is disturbed in patients with AD. These patients may have changes in reading ability early in the course of their disease before clinical alexia or abnormalities are apparent on standard reading tasks. METHOD: Reading competence was evaluated by recording eye movements during reading in 14 patients with mild to moderate clinically probable AD and 14 age- and education-matched controls. RESULTS: All patients with AD could recognize letters and words and could understand written material of similar difficulty. Despite successful reading comprehension among the patients with AD, their oculographs showed slowed reading and irregular eye movements. Compared with controls, the patients with AD did not differ in saccadic duration; however, they had significantly longer fixation times, more forward saccades per line of text, and more saccadic regressions. In addition, increased reading difficulty significantly correlated with a scale of dementia severity in the patients with AD. CONCLUSIONS: This pattern of eye movements corresponds to increased text difficulty and probably represents difficulty with lexical-semantic access in AD. These results suggest that disordered eye movements can signal difficulties in reading ability in AD even before complaints of reading difficulty or abnormalities on reading tests and may be a means of identifying linguistic impairment early in this disorder.

Aged↗
PubMed1999

[The significance of the study of aphasia, apraxia and agnosia at present time].

Neuropsychology initiated by the study of aphasia, apraxia and agnosia had been regarded as one division of psychiatry. This is one of the reasons why neuropsychology is minor territory in neurology. Some people say that neuropsychology seems difficult to understand, not scientific, not useful and is rather a man's taste than a medicine. I try to respond in this paper to these critics by way of analyzing our own cases while insisting on the today's importance of the study of aphasia, apraxia and agnosia. Our personal cases consist of the following three categories. 1) Primary progressive apraxia: proposal of the symptomatic concept suggested by the investigation of our own eight cases and those in the literature. 2) Musical alexia with agraphia in a trombone player: study of the cerebral localization in a person with special ability. 3) Disturbance of reaching proposal of intracerebral pathways in kinesthesia. Therefore it is highly possible that the significance of the study of aphasia, apraxia and agnosia should become enlarged now and after; and it seems urgent to answer its need that younger neurologists participate in this area.

Aged↗
PubMedDate not supplied

The use of reaction time measures to evaluate nonword reading in primary progressive aphasia.

We reported on a subject with nonfluent primary progressive aphasia (PPA), NL, who demonstrated an impaired ability to make rhyme judgments (Dowhaniuk, Dixon, Roy, Black, & Square, in press). Our hypothesis was that these deficits represent a precursor to phonological alexia. However, no definitive evidence supported the existence of a phonological reading impairment as NL made relatively few errors reading nonwords. To further evaluate NL's nonword reading, nonword and real word reaction times were compared. NL's reaction times were significantly longer for only nonwords compared to the slowest control subject. We then assessed the first two stages of processing involved in nonword reading (Coltheart, 1996). NL did not demonstrate deficits with graphemic parsing or phoneme assignment. His continuing problems with auditory rhyme judgments support the presence of a phonological processing deficit not specific to reading. We conclude that reaction time measures allow for the detection of subtle nonword reading deficits.

Aged↗
PubMedDate not supplied

Dissociation of reading strategies: letter-by-letter reading in the native language and normal reading in the learned language. A case study.

In letter-by-letter reading, which is typically observed in Dejerine's (1892) "pure alexia," oral reading seems to be mediated by the naming of the constituent letters of the printed sequence: reading time rises abnormally as a function of the number of letters of the target item. We describe a patient with fluent aphasia who showed the unusual pattern of letter-by-letter reading together with surface dyslexia in her native language (French) and apparently normal reading in the second, learned language (English). Thus, letter-by-letter reading should be considered as a description of a symptom rather than the consequence of a unique type of functional impairment.

Brain Injuries↗
PubMedDate not supplied

[Crossed aphasia: description of a case].

We describe a new case of crossed aphasia in a right-handed patient with a right hemispheric lesion. A right-handed man, 76 year-old, developed a sudden left hemiparesis with sensitive impairment and mutism. He has neither family history of left handeness or ambidexterity or vascular risk factors. CT cerebral scan showed a large infarct of the middle cerebral artery on the right side, with haemorrhagic suffusion. Cerebral MRI and EEG-cartography confirmed the indemnity of the left hemisphere. Aphasia studies confirmed a mutism with spared verbal comprehension, but alexia was present. A year later, left hemiparesis was recovered but aphasia remained. Crossed aphasia is rarely seen. It is caused by a right hemispheric lesion in right-handed subjects. Fluency is most commonly impaired. At onset, mutism is the common symptom, which evolves to expressive aphasia. Several hypothesis have been raised about the possible mechanisms involved. The few number of PET or SPECT studies performed in these patients have disclosed extensive areas of hypometabolism in the right hemisphere, that exceed the size of the image observed with CT scan or MRI.

Aged↗
PubMed2000

Alterations in the functional anatomy of reading induced by rehabilitation of an alexic patient.

OBJECTIVE: The goal of the study was to measure regional cerebral blood flow (CBF) in a stroke patient with acquired phonologic alexia before and after therapy using the Auditory Discrimination in Depth (ADD) program. BACKGROUND: After rehabilitation of acquired language disorders, functional imaging can detect activity in brain structures that do not mediate language during normal conditions. However, the anatomic correlates of recovery or rehabilitation from acquired reading disorders are largely undescribed. METHODS: Cerebral SPECT scans were obtained before and after the intervention with Auditory Discrimination in Depth. The first and last activation tasks necessitated that the patient read nonwords during radionuclide uptake. Another (control) scan was acquired during performance of a nonlinguistic task shortly before the end of the ADD program. RESULTS: Before therapy, the right hemisphere was inactive during nonword reading relative to the nonlinguistic task. After treatment, nonword reading increased cerebral blood flow in the posterior right perisylvian cortices homologous to the dominant hemisphere areas engaged by reading. Brain activity also increased in Broca's area of both hemispheres. CONCLUSIONS: Dyslexia rehabilitation may facilitate right-hemisphere cortical networks in the reading process and increase engagement of phonologic articulatory motor representations in Broca's area.

Dyslexia↗
PubMed2001

Deficits in cortical visual function.

Lesions of extrastriate cortex cause selective defects in visual function. Damage to portions of the "ventral stream" in medial and inferior occipitotemporal cortex lead to impaired perception of color or various specific visual object recognition defects, such as prospagnosia, the inability to recognize familiar faces, and alexia, the inability to read. The latter must be distinguished from a variety of other reading defects related to primary visual, attentional, linguistic, or ocular motor impairments. Damage to the "dorsal stream" in lateral occipito-temporo-parietal regions impairs visuospatial capabilities, leading to akinetopsia (impaired motion perception) or Balint's syndrome, a loosely bound triad of simultanagnosia, optic ataxia, and ocular motor apraxia. Topographagnosia can occur with ventral or dorsoal lesions for different reasons. Considerable evidence has accumulated showing that residual vision or even "blindsight," which is visual perception in the absence of awareness, can persist after lesion of striate cortex in some patients.

Brain Diseases↗
PubMedDate not supplied

[Space-occupying lesions of the occupital lobe of the cerebral cortex].

The authors report 90 cases of space occupying lesions originating in the occipital lobe, including 58 primary (26 malignant gliomas, II "benign" gliomas, 19 meningiomas, I sarcoma nad I hémangioblastoma (and 32 secondary masses (i. e. 16 metastatic tumors, 15 abcesses and I hydatid cyst). The onset of clinical features was progressive (gradual increase of intracranial pressure : 59 p. 100) rather than acute (41 p. 100 mostly as a visual (II) or a non visual (10) epileptic seizure). The time elapsed between the first symptom and the surgical procedure in any case appeared to be much shorter than in masses with other hemispheric localisation. This is thought to be due to the precocity and the intensity of the increased intracranial pressure, in relation to the blocage of posterior venous drainage. Increased intracranial pressure : only 7,7 p. 100 of the patient were free of IIP. Fundal changes are of little value in excluding this finding since no less than 3 months of evolution are necessary for their appearence. Visual disturbances consisted of acute obscurations (7.7 p. 100), controlateral deviations of head and eyes (3.3 p. 100) and visual field defects = 10 p. 100 of the patients were comatose and unable to be examined, 16.6 p. 100 had normal visual field. All the others had visual field defects wich could be evaluated by campimetric examination in only 26.6 p. 100. These included 14 hemiopias (7 without macular sparing) and 10 quadranopsia, always with incongruence (4 superior and 6 inferior). When the mass was strictly occipital, the same disparity was observed. Finally these visual field defects appeared to be variable and could well recover after surgery. Visual hallucinations were mostly of elementary type (21 p. 100) and always controlateral in cases of strictly occipital lesions. Elaborate hallucinations were rare (2 patients with extensive lesions). 8.8 p. 100 suffered from visual illusions wich always were related to large and right-sided masses. Disturbances of higher functions : Alexia was seen in 33 p. 100 of the left-sided masses (24 p. 100 "agraphic", 9 p. 100 "pure word blindness") Space agnosias of different type was found in 10 p. 100 of the patients, sometimes with purely occipital tumors.

Adolescent↗
PubMed1975

Frontal agraphia, (including a case report).

Frontal agraphia has always been a subject of interest, although very few documented case reports have been published. A 57 year old male clerk, suffering from adenocarcinoma of the signoid colon, presented with mild headache and difficulty in writing. Minor features of dysphasia could be detected, but there were no alexia, agnosia or apraxia. Brain scan and angiography confirmed a metastasis in the posterior part of the left prefrontal region. The patient was able to write single letters, and had no difficulty with automatic writing or copying. The writing of words and of sentences was more affected. After a brief review of the literature and discussion, the authors concluded that frontal agraphia is related to frontal lobe diorders, especially the inability to translate verbal signals into motor behaviour (i.e. writing).

Adenocarcinoma↗
PubMed2002

Angular gyrus syndrome mimicking depressive pseudodementia.

A 67-year-old left-handed woman with a diagnosis of pseudodementia was being treated for depression with little benefit. Neuropsychological evaluations revealed features of angular gyrus syndrome, namely, agraphia, alexia, Gerstmann's syndrome and behavioural manifestations such as depression, poor memory, frustration and irritability. A computed tomographic scan showed a right occipito-temporal infarction, which had occurred 18 months earlier. The patient demonstrated aspects of language dysfunction associated with the syndrome and showed reversed lateralization of cerebral functions. Recognizing and distinguishing between angular gyrus syndrome and depression is important because the appropriate therapies differ. The use of the term pseudodementia can be misleading.

Aged↗
PubMedDate not supplied

[Cerebral activation during Stroop's test in a case of early focal brain injury].

INTRODUCTION: Functional magnetic resonance imaging (fMRI) offers an important advantage over other functional neuroimaging techniques used with children because of its harmlessness. Previous studies conducted with adults with alexia suggested two ways the brain can reorganise reading after a brain injury affecting the left hemisphere, one contralateral and the other ipsilateral. CASE REPORT: We describe a study carried out using fMRI of a 10 year old girl with an injury to the left hemisphere caused by a fishing harpoon when she was 6 years old. As a result of the accident the girl presented a right hemiparesia. The girl s parents and teachers also reported difficulties in the acquisition of reading writing and arithmetic, as well as a certain degree of attentional deficit. An fMRI exploration was performed while the girl was doing the Stroop test. The structural MR images showed left hemisphere cortical lesions in the orbital and angular gyrus regions, in addition to the caudate and putamen nuclei, and in the inferior longitudinal bundle. The fRMI revealed a strong overactivation of the right dorsolateral frontal cortex, in the evaluation of interference, and activations of the right angular and bilateral supramarginal gyri, in the evaluation of word reading. CONCLUSION: The functional study suggests the existence of a reorganisation of reading that is both intra and inter hemispheric.

Brain↗
PubMed2003

[Semiology of sensorial integration: visual disorders of cerebral origin].

Visual disorders occur after lesions of brain areas involved in visual processing. Bilateral lesions located in occipital, temporal or parietal lobes leads to cerebral blindness, visual agnosia, prosopagnosia, alexia or visuospatial disorders. These visual disorders are difficult to understand by the patient. They see but do not recognise, or they can't see but their eyes are normal, spectacles can not improve their disorders. The diagnosis will be done after a systematic ophthalmologic, neurologic and neuropsychologic examination.

Brain Diseases↗