Subangular alexia without agraphia or hemianopsia

A 40 year old right-handed woman underwent resection of an unruptured vascular malformation which was located just deep to the left posterior insula. Postoperatively she demonstrated a transient syndrome of alexia without agraphia or hemianopsia. Analysis of her postoperative findings, in conjunction all available anatomical data, let to the conclusion that the responsible lesion was in the white matter of the left occipitotemporal region, below the angular gyrus and lateral to the lateral ventricle. Hence the lesion in the present case was truly subangular, and is therefore distinctly differentiated from the classical lesion in alexia without agraphia, which may be described as splenio-occipital.