Kawahata N, Nagata K
Department of Neurology, Research Institute for Brain and Blood Vessels-Akita, Japan.
J Clin Exp Neuropsychol. 1989 Oct;11(5):645-64. doi: 10.1080/01688638908400922.
A 61-year-old right-handed man fell downstairs and was found unconscious. There was no abnormality in the general physical examinations. Neurological examinations revealed a quadrantanopia. Neuropsychological examination revealed an impairment in recent verbal memory, alexia, agraphia, object agnosia, color naming difficulty, prosopagnosia, and visuospatial constructional disability. CT scan demonstrated subcortical hematomas in the temporo-occipital regions of both hemispheres. MRI demonstrated extensive low-intensity lesions in the lingual, fusiform and posterior inferior temporal gyri on both hemispheres. Both inferior longitudinal fasciculi were also affected. His neuropsychological deficits seem best described as a typical form of associative visual agnosia. From the results of neuroradiological findings, the authors emphasize that associative visual agnosia might be produced by an intrahemispheric disconnection between the visual cortices and the temporal lobes which are supposed to be the storage site of the engrams of visual memories. Moreover, the neuropsychological findings suggest that the visuo-constructional ability to convert the two-dimensional input to the three-dimensional construction and the capacity of three-dimensional imagination were severely impaired in our patient. It was considered that these neuropsychological features play an important role in the recognition difficulties of associative visual agnosia.
一名61岁的右利手男性从楼梯上摔下，被发现时已昏迷。全身体格检查未发现异常。神经学检查发现象限盲。神经心理学检查显示近期言语记忆受损、失读症、失写症、物体失认症、颜色命名困难、面容失认症和视觉空间构建障碍。CT扫描显示双侧颞枕叶皮质下血肿。MRI显示双侧舌回、梭状回和颞下回后部广泛低信号病变。双侧下纵束也受到影响。他的神经心理学缺陷似乎最能被描述为一种典型的联想性视觉失认症。根据神经影像学检查结果，作者强调联想性视觉失认症可能是由视觉皮质与颞叶之间的半球内联系中断所致，而颞叶被认为是视觉记忆痕迹的存储部位。此外，神经心理学检查结果表明，我们的患者将二维输入转换为三维构建的视觉构建能力和三维想象能力严重受损。据认为，这些神经心理学特征在联想性视觉失认症的识别困难中起重要作用。
