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CASE REPORT
Complete abolition of reading and writing ability with a third ventricle colloid cyst: implications for surgical intervention and proposed neural substrates of visual recognition and visual imaging ability
  1. Lynne Ann Barker1,
  2. Nicholas Morton2,
  3. Charles A J Romanowski3,
  4. Kevin Gosden2
  1. 1Department of Psychology, Sheffield Hallam University, Sheffield, UK
  2. 2Neurorehabilitation Services, Rotherham, Doncaster and South Humber Mental Health NHS Foundation Trust, Doncaster, South Yorkshire, UK
  3. 3Department of Academic Radiology, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, South Yorkshire, UK
  1. Correspondence to Dr Lynne Ann Barker, l.barker{at}shu.ac.uk

Summary

We report a rare case of a patient unable to read (alexic) and write (agraphic) after a mild head injury. He had preserved speech and comprehension, could spell aloud, identify words spelt aloud and copy letter features. He was unable to visualise letters but showed no problems with digits. Neuropsychological testing revealed general visual memory, processing speed and imaging deficits. Imaging data revealed an 8 mm colloid cyst of the third ventricle that splayed the fornix. Little is known about functions mediated by fornical connectivity, but this region is thought to contribute to memory recall. Other regions thought to mediate letter recognition and letter imagery, visual word form area and visual pathways were intact. We remediated reading and writing by multimodal letter retraining. The study raises issues about the neural substrates of reading, role of fornical tracts to selective memory in the absence of other pathology, and effective remediation strategies for selective functional deficits.

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