Investigation and Comparison of the Agraphia Features in Cortical and Subcortical Lesions

Abstract

Language impairment is often a result of cortical damage.However, İt was described also resulted from subcortical lesions. We examined relative incidence and severity of graphia and drawing impairment after cortical and subcortical strokes and whether there were qualitative difference between cortical and subcortical damage patients drawing functions.Graphia and drawing tests was administered to all patients (50 patients with cortical-30left, 20 right side lesions and 30 patients with subcortical lesions-14 left, 16 right side).Drawing impairment in patients with cortical lesions was more strongly associated withimpairment of other cognitive abilities. Subcortical lesions didn't show so severe impairment in drawing function. Writing and drawing was more severely impaired in the cases of left cortical or subcortical lesions than those on the right. Drawing function impairments observed in right sided lesions were found related to the hemispatial neglect. The most important defects found in agraphia of left cortical lesions was found to be impairment of spontaneous graphia, clear copy deficiency, agramatizm, structural errors of the letter and sentence, mistake word and letter usage, illegible sentence, recorrection, had composition. In right sided cortical lesions, additional to structural abnormalities, it was detected some impairment in horizontal graphia and drawing disturbances, neglect, using in wrong way position of the word and letter, more definite spontaneous graphia and drawing impairment. There was not any significant difference between right and left sided subcortical lesions,both of them showing more definite impairment in spontaneous writing than that in drawing simplification of the writing and figure, spatial relationship desorientation of the drawing-page, impairment of the lines and angles production.