 |
Case Report
Alexia without agraphia in a young adult with ischemic stroke: A case report
1 Staff of Department of Neurology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
2 Resident of Department of Neurology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Address correspondence to:
Fasihah Irfani Fitri
Staff of Department of Neurology, Faculty of Medicine, Universitas Sumatera Utara, Jalan Dr. Mansyur No. 5, Medan 20155, North Sumatra,
Indonesia
Message to Corresponding Author
Article ID: 101333Z01FF2022
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Fitri FI, Pranata H, Nasution I. Alexia without agraphia in a young adult with ischemic stroke: A case report. Int J Case Rep Images 2022;13(2):91–95.ABSTRACT
Introduction: Ischemic stroke in young adults is less common than in older adults, but its occurrence warrants further investigation to determine the cause and appropriate treatment to improve outcome. One of the stroke manifestations is a disconnection syndrome, such as alexia without agraphia, a condition in which a patient cannot read but the ability to write remain relatively intact. Pure alexia is associated with the lesion in the medial occipitotemporal lobe in the dominant hemisphere, also known as the visual word form area (VWFA).
Case Report: Here we report a case of a 30-year-old male, who presented with an acute complaint of inability to read without any difficulty in writing, accompanied by right homonymous hemianopia which occurred two days before admission. Initial brain scan was normal. However, the repeated brain scan two weeks after admission showed infarction in the left occipitotemporal lobe. He had no known previous vascular risk factors other than obesity. The evaluation during admission showed high blood pressure, dyslipidemia, and suggestive of autoimmune disease, all of which might contribute to the ischemic stroke occurrence. During follow-up he was referred for the neuropsychological assessment and rehabilitation as well as to the outpatient clinic for use of antithrombotic as secondary prevention. He showed gradual improvement in his symptoms after sixth months follow-up.
Conclusion: Stroke in young adults is an increasing problem nowadays due to its rising incidence and more diverse pathogenetic mechanisms and related high morbidity. One of the neurological deficits found in stroke is a disconnection syndrome such as alexia without agraphia in which there is an acquired inability to read with relatively preserved writing ability. Pure alexia found in this case was due to an infarction of the occipitotemporal lobe that disconnects primary language areas from incoming visual information.
Keywords: Alexia, Ischemic, Pure, Stroke, Young adult
SUPPORTING INFORMATION
Author Contributions
Fasihah Irfani Fitri - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Heru Pranata - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Iskandar Nasution - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Fasihah Irfani Fitri et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
