Leiguarda R, Carrea R
Acta Neurol Latinoam. 1977;23(1-4):89-101.
Two cases of alexia without agraphia, one due to a cerebrovascular accident which improved spontaneously and the other in a cerebral abscess partially recovered after surgical treatment are presented. Both were anatomically verified by computed tomography. The second was also verified at surgery. A small well localized lesion of the fusiform and lingual gyri in the dominant hemisphere can lead to alexia without agraphia. The lack of involvement of the optic radiation and calcarine fissure explain the abscence of visual field defects and hence the purest type of this syndrome as shown in our first case. The involvement of the splenium of the corpus calosus and related forceps majors seems essential for a long lasting reading defect. The integrity of the dorsal or superior splenium is responsible for the abscence of the color warning defect found on about 30% of the cases of pure word blindness. The severity and ultimate progression of the alexia will depend not only upon the extension of the dominant occipital lesion but of its association with the damage of other possible pathways. A slowly growing and potentially treatable expanding lesion, as in our second case, can also produce an almost pure form of the syndrome. It appears to us that the wider use of CT will allow on the near future will lead to a better knowledge of the anatomical lesions and a better understanding of this fascinating syndrome.
本文报告了两例失读不伴失写症患者，一例因脑血管意外导致，后自发好转；另一例为脑脓肿，手术治疗后部分恢复。两例均经计算机断层扫描进行解剖学证实，第二例还在手术中得到验证。优势半球梭状回和舌回的小而局限的病变可导致失读不伴失写症。视辐射和距状裂未受累可解释无视野缺损，因此如我们的第一例所示，这是该综合征最纯粹的类型。胼胝体压部及相关的主要钳状束受累似乎是导致长期阅读缺陷的关键。背侧或上压部的完整性可解释约30%的纯词盲病例中不存在颜色警告缺陷的原因。失读症的严重程度和最终进展不仅取决于优势枕叶病变的范围，还取决于其与其他可能通路损伤的关联。如我们的第二例所示，缓慢生长且可能可治疗的扩展性病变也可产生几乎纯粹形式的综合征。在我们看来，计算机断层扫描在不久的将来更广泛的应用将使人们更好地了解解剖学病变，并更好地理解这一迷人的综合征。
