INTRODUCTIONVery few countries in the world use languages that can be written in both ideogram, a graphic record of a meaning, and phonogram, a graphic record of a sound. Reading or writing impairment of these two written systems after brain damage may provide information about whether or not phonogram and ideogram are mediated in different brain regions.Many studies of phonogram and ideogram originated from Japanese in which dual orthographic system is employed; Kana (phonograms) and Kanji (ideograms) (1-12). Japanese authors have found a double dissociation between Kana and Kanji impairments in brain-damaged patients and reported that Kanji is processed mainly in left posterior inferior temporal area (4-9). On the contrary, there have been few studies on Korean written language (13,14), another orthographic system that also uses both phonogram (Hangul) and Chinese ideogram (Hanja). We report a man with alexia and agraphia for Hanja but intact reading and writing for Hangul after a left posterior inferior temporal lobe infarction. Interestingly, the patient was an expert in Hanja as he had been a calligrapher over 40 years.
MATERIALS AND METHODS
Case ReportA 64-yr-old right-handed man was admitted to our department because of a blurred vision and paresthesia on the right extremities. Three days before admission, on waking up, he felt narrowed right visual field with dizziness and headache in addition to paresthesia and clumsiness in the right extremities. On the next morning, he noticed a weakness on his right arm and could not remember the names of his close friends.His past medical history revealed a gout 13 yr before, a pneumonia 10 yr before, and hypertension for several years for which he had been on antihypertensive drugs intermittently. The history of diabetes mellitus or episodes of stroke was denied. He was a social drinker and non-smoker. He was educated for 12 yr and learned Hanja since childhood. He had been a Hanja calligrapher over 40 yr and he once received an award in a famous national calligraphy contest.On physical examination, blood pressure was 150/100 mmHg but heart beat was regular. He was fully conscious and oriented to time, place, and person. He scored 27/30 on