Sato M, Yasui N, Isobe I, Kobayashi T
No To Shinkei. 1982 Oct;34(10):939-45.
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.
据报道，有一名49岁的右利手女性。她因双侧颞顶叶病变出现了纯词聋和听觉失认症。左侧病变是由于左侧颈动脉动脉瘤破裂导致蛛网膜下腔出血后，左大脑前动脉和大脑中动脉发生血管痉挛所致；右侧病变是由于脑室-腹腔分流术后出现皮质下血肿所致。发病7个月后，CT扫描显示双侧颞顶叶区域有异常低密度区。神经心理学检查结果如下：没有诸如言语错乱、找词困难或自发书写、阅读及计算障碍等失语症状。但她的听觉理解严重受损，既不能跟读测试者说出的单词，也不能听写。尽管她对纯音、脑干听觉诱发电位和听觉诱发电位的听力敏感度正常，但她也无法识别有意义的声音和音乐。我们讨论了听觉识别的神经心理学机制，并推测每个半球可能在二级听觉区处理言语和非言语听觉刺激。听觉输入可能在左侧联合区被识别，这是该机制的最终水平。该病例的纯词聋和听觉失认症可能是由右侧二级听觉区、左侧初级听觉区与左侧二级听觉区之间以及左右二级听觉区之间的通路中断所致。
