Neuropsychological analysis of a case of crossed dysphasia verified at postmortem

A case is reported of crossed dysphasia in a right-handed monolingual patient, where neuropathological verification of the unilateral site of the lesion was obtained within a year of detailed neuropsychological assessment. The patient's pattern of language impairment was characterized by agrammatic speech and relatively preserved naming ability. In addition, the patient had good repetition, poor comprehension, and marked impairment on visuospatial tasks. Neuropathological investigations showed a large area of infarction affecting cortex, white matter, and subcortical structures in the right hemisphere. The possibility is discussed of a distinction between two types of crossed dysphasia with either dissociated or simultaneous language and visuospatial deficits due to reversed representation of hemispheric specific functions or transfer of most cognitive functions to the right hemisphere.