Disconnection and recognition of faces. A case with lesions of the left visual cortex and the splenium

1988 
: We report the clinical findings in a case of alexia without agraphia, due to a left posterior cerebral artery infarction, in which C.T. showed occipital and splenial lesions. There were in addition a right homonymous hemianopsia and agnosia for colors, objects and pictures, with both associative and disconnective aspects. The hypothesis of an occipito-occipital disconnection, depriving the left visual associative areas of inputs, could explain this agnosia. The most striking findings in this case was, besides an anomia for faces, a peculiar difficulty to recognize her own face. The patient seemed to recognize herself. The patient spoke about herself in the third person, giving genuine autobiographical details, without being able to say: "it is me". This phenomenon is discussed in terms of disconnection: the right hemisphere sending information from the semantic field evoked by her own face, through the anterior part of the corpus callosum, to the left hemisphere. We discuss the hemispheric contribution within cognitive experience, and the role of language concerning the conscious experience in man.
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