교차 실어증과 심한 좌측 편무시를 보인 우뇌반구 경색증 1례

Abstract

Background : Hemispheric lateralization of cognitive functions shows individual variation and is related to multiple factors such as handedness, gender and early head injuries. We report a patient with crossed aphasia wherein neuropsychological tests suggested that both language and visuospatial functions are represented in the right hemipshrere. Case Report : A 60-year-old right-handed monolingual man developed speech disturbance and cognitive decline following a right temporo-parietal infarction. Neuropsychological examinations demonstrated a language disturbance consistent with Wernickes aphasia. In addition, there were right-left disorientation, body part identification deficits with finger agnosia, dyscalculia, and severe left hemispatial neglect on line bisection, target cancellation tasks and copying and representational drawing of figures. An agraphia was not present. Conclusion : Our patient, following a right hemispheric injury, developed aphasia as well as severe and persistent hemispatial neglect. These results suggest that both the language function and the spatial cognition are represented in the right hemiphere. Dissociation between four components of Gerstmann syndrome in this patient may reflect another anomalous lateralization of cognitive functions. Korean Journal of Stroke 1999;1(2): 246~250