Neurosychological Studies of the Relation between Lesion Localization by MRI and the Disorders of Higher Brain Functions.

本文分析了11例单纯失读症患者的神经体征、症状与CT、MRI的关系。结果显示，枕下皮层（舌回和梭状回）和左半球下皮层白质的损伤是产生纯粹失读症的必要和充分条件。与传统观点相反，我们认为纯粹的失读症可能发生在没有胼胝体损伤的情况下。同时也检查了许多有不同神经体征和症状的患者。其中，最重要和最令人感兴趣的案例如下：1。左单侧汉字失写症，假名失写症1例：该患者经MRI诊断为胼胝体后体病变，提示汉字和假名的神经通路不同，不仅是半球内的，而且是半球间的。2.单纯文字性耳聋1例：该患者经MRI诊断为左侧颞顶皮层皮层下区病变，韦尼克区完整。从这一病变来看，纯粹的单词耳聋是由于左侧听觉辐射和右侧听觉皮层胼胝体通路的相关断开而使韦尼克区与听觉信息隔离而发生的。

The relation between neurological signs and symptoms and computed tomography (CT) and magnetic resonance imaging (MRI) was examined in 11 cases of pure alexia. The results revealed that lesions of the inferior occipital cortex (lingual and fusiform gyri) and the subjacent white matter of the left hemisphere were necessary and sufficient to produce pure alexia. And contrary to conventional view, it is suggested that pure alexia may occur without lesions of the corpus callosum.Also many patients with various neurological signs and symptoms were examined. Among them, the important and the most interest cases were as follows: 1.a patient with left unilateral agraphia for kanji but not for kana: This patient was diagnosed by MRI as having a lesion of the posterior body of the corpus callosum, and it is suggested that different neural pathways are used for kanji and kana not only intrahemispherically but also interhemispherically. 2.a case with pure word deafness: This patient was diagnosed by MRI as having a lesion of the subcortical area in left temporoparietal cortex with intact Wernicke's area. From this lesion, it is suggested that the pure word deafness occurred as the isolation of Wernicke's area from auditory information by the associated disconnection of the left auditory radiation and the callosal pathway from the right auditory cortex.