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Alexia without agraphia (pure alexia) is considered one of the classic disconnection syndromes. Patients are unable to recognize visual letter or word symbols, but retain the ability to write and often have right homonymous hemianopia.1 Pure alexia without a visual defect is a rare variant.1-3
Few reports show pathologic verification of the correlation of the lesions location or clinical-neuroimaging. We describe a patient with pure alexia without hemianopia as the first published example caused by a spontaneous hematoma involving extrastriate visual cortex of the left occipital lobe, demonstrated on MRI and single-photon emission computed tomography(SPECT).
Case report. A 40-year-old right-handed man with a history of minimal change glomerulonephritis and long-standing hypertension was otherwise well until the day of admission, when he had an acute occipital headache and inability to read. Aside from a blood pressure of 150/95 mm Hg, the general examination on admission was unremarkable.
Neurologic examination revealed him to be oriented clearly and alert with fluent speech. He could name, repeat, and comprehend appropriately. He was able to write …
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