Iwanaga Keisuke, Satoh Akira, Satoh Hideyo, Seto Makiko, Ochi Makoto, Tsujihata Mitsuhiro
Section of Neurology, Nagasaki Kita Hospital.
Rinsho Shinkeigaku. 2011 May;51(5):354-7. doi: 10.5692/clinicalneurol.51.354.
A 66-year-old, right-handed male, was admitted to our hospital with difficulty in recognizing faces and colors. He had suffered a stroke in the right occipital region three years earlier that had induced left homonymous hemianopsia, but not prosopagnosia. A neurological examination revealed prosopagnosia, color agnosia, constructional apraxia, and topographical disorientation, but not either hemineglect or dressing apraxia. The patient was unable to distinguish faces of familiar persons such as his family and friends, as well as those of unfamiliar persons such as doctors and nurses. Brain MRI demonstrated an old infarction in the right medial occipital lobe and a new hemorrhagic infarction in the left medial occipital lobe, including the fusiform and lingual gyrus. It is unclear whether a purely right medial occipital lesion can be responsible for prosopagnosia, or whether bilateral medial occipital lesions are necessary for this occurrence. The current case indicated that bilateral medial occipital lesions play an important role in inducing porsopagnosia.
一名66岁的右利手男性因面部和颜色识别困难入院。他三年前在右侧枕叶区域发生过中风，导致左侧同向性偏盲，但未出现面孔失认症。神经系统检查发现面孔失认症、颜色失认症、结构性失用症和地形定向障碍，但未发现偏侧忽视或穿衣失用症。患者无法区分家人和朋友等熟悉人的面孔，以及医生和护士等不熟悉人的面孔。脑部MRI显示右侧枕叶内侧有陈旧性梗死，左侧枕叶内侧包括梭状回和舌回有新的出血性梗死。尚不清楚单纯的右侧枕叶内侧病变是否可导致面孔失认症，或者双侧枕叶内侧病变对于这种情况是否必要。目前的病例表明双侧枕叶内侧病变在诱发面孔失认症中起重要作用。
