Alexia and agraphia in acute and chronic stroke

Introduction Reading and writing are increasingly important in society. More transactions and communications take place over the Internet each day. Stroke or other focal brain injuries can selectively impair reading and/or writing, causing important deficits in these daily interactions. Although not immediately apparent on the traditional neurological examination, alexia and agraphia can be disabling and dehumanizing. Furthermore, these deficits may be the only functional sequel of certain types of stroke, such as posterior watershed infarct, embolism to the left posterior parietal cortex, or occlusion of the left posterior cerebral artery (PCA). Therefore, assessment of reading and writing is an essential component of a complete neurological examination in patients with suspected stroke.Presentations of disordered reading and writingReading and spelling are complex tasks with a number of processing components, each of which can be individually impaired by focal brain lesions. It is possible to determine the component of the task that is disrupted by evaluating performance across a variety of tasks and by considering the types of error made by the patient.