Ideogram reading in alexia.

A case of alexia with agraphia in a Japanese patient is presented. Reading difficulty was severe in words composed of phonograms (Kana), while reading of words composed of Ideograms (Kanji) was better preserved. Writing was severely impaired in both types of characters. Occlusion of the angular branch of the left middle cerebral artery was demonstrated by carotid arteriography and was considered responsible for the symptoms. Two additional cases of alexia with agraphia from the Japanese literature are reviewed. Their linguistic features were similar to the present case. A hypothesis of a functional disconnexion between visual and auditory-oral systems is proposed to explain why Kana processing was more severly affected than Kanji processing.