Pure word deafness in a patient with bilateral ischemic stroke in the superior temporal gyrus (STG)

Situating word deafness within aphasia recovery: A case report

Word deafness is a rare neurological disorder often observed following bilateral damage to superior temporal cortex and canonically defined as an auditory modality-specific deficit in word comprehension. The extent to which word deafness is dissociable from aphasia remains unclear given its heterogeneous presentation, and some have consequently posited that word deafness instead represents a stage in recovery from aphasia, where auditory and linguistic processing are affected to varying degrees and improve at differing rates. Here, we report a case of an individual (Mr. C) with bilateral temporal lobe lesions whose presentation evolved from a severe aphasia to an atypical form of word deafness, where auditory linguistic processing was impaired at the sentence level and beyond. We first reconstructed in detail Mr. C's stroke recovery through medical record review and supplemental interviewing. Then, using behavioral testing and multimodal neuroimaging, we documented a predominant auditory linguistic deficit in sentence and narrative comprehension-with markedly reduced behavioral performance and absent brain activation in the language network in the spoken modality exclusively. In contrast, Mr. C displayed near-unimpaired behavioral performance and robust brain activations in the language network for the linguistic processing of words, irrespective of modality. We argue that these findings not only support the view of word deafness as a stage in aphasia recovery but also further instantiate the important role of left superior temporal cortex in auditory linguistic processing.

Pure word deafness due to bilateral temporal lobe ischemic stroke occurring at different time points over the years: a case report on the insight of brain language network reorganization

Here we present a case of a native Greek male patient who presented clinically with sudden onset pure word deafness after an ischemic stroke in the temporoparietal region of the right hemisphere, but who had suffered an ischemic stroke 9 years previously in an adjacent area of the left hemisphere, causing aphasic symptoms which resolved quickly and almost completely. What makes this case interesting and novel is that it is the first case describing a patient whose ventral language comprehension circuit did not reorganize successfully due to damage of the adjacent right hemisphere language areas at a subsequent time.