[A case of pure word deafness and auditory agnosia associated with bilateral temporo-parietal lesions].

A-49-year-old right-handed female was reported. She showed pure word deafness and auditory agnosia because of bilateral temporo-parietal lesions. The left lesion resulted from angiospasm of the left anterior and middle cerebral arteries after subarachnoid hemorrhage due to a ruptured aneurysm of the left carotid artery, and the right one resulted from subcortical hematoma after the V-P shunt operation. CT scan revealed the abnormal low density area on the bilateral temporo-parietal regions seven months after onset. Neurophychological findings were as follows: there were no aphasic symptoms such as paraphasia, word finding difficulties, or disturbances of spontaneous writing, reading and calculation. But her auditory comprehension was severely disturbed, and she could neither repeat words after the tester nor write from dictation. She also could not recognize meaningful sounds and music in spite of normal hearing sensitivity for pure tone, BSR and AER. We discussed the neuropsychological mechanisms of auditory recognition, and assumed that each hemisphere might process both verbal and non-verbal auditory stimuli in the secondary auditory area. The auditory input may be recognized at the left association area, the final level of this mechanism. Pure word deafness and auditory agnosia of this case might be caused by the disruption of the right secondary auditory area, the pathway between the left primary auditory area and the left secondary auditory area, and between the left and right secondary auditory areas.