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Left hemisphere pathways in reading

Inferences from pure alexia without hemianopia

University of Southern California Neurobehavior Clinic and the Departments of Neurology (Drs. Henderson and Teng) and Medicine (Dr. Weiner). University of Southern California School of Medicine, Los Angeles, CA; and the Aphasia Research Center, Veterans Administration Medical Center, and the Department of Neurology (Dr. Friedman), Boston University School of Medicine, Boston, MA.

In pure alexia, reading is impaired despite almost normal speech, spelling, and writing. We studied a righthanded man with pure alexia, but no hemianopia. He had more difficulty reading longer words (word-length effect), but had no selective reading impairment in phonologic or semantic analysis. Clinical-CT correlation suggests that (1) left hemisphere visual pathways crucial for reading arise from or pass close to the left occipitotemporal or inferior temporal gyrus, and (2) relevant transcallosal fibers from the right hemisphere course inferior to the posterior horn of the left lateral ventricle before ascending to left hemisphere language areas.

Address correspondence and reprint requests to Dr. Henderson, Department of Neurology, Unit I. Room 5641, University of Southern California School of Medicine. 1200 North State Street, Los Angeles, CA 90033.

Presented in part at the 108th annual meeting of the American Neurological Association, New Orleans, October 4, 1983.

Accepted for publication November 1, 1984.

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