1. What is the term describing the patient’s inability to recognize familiar faces?
Prosopagnosia
2. What is the term describing the patient’s inability to recognize familiar objects and places?
Environmental agnosia
3. What is the term describing the patient’s difficulty with color identification?
Color agnosia (specifically, central achromatopsia)
4. What is the specific anatomical location of the lesion producing the above findings?
Bilateral inferior, medial occipital and/or temporal lobes (ie, lingual and/or
medial occipitotemporal [fusiform] gyri)
5. Are the above findings due to her most recent lesion or are they due to a combination of her present lesion plus one of her past lesions? If so, which of her prior problems is pertinent to her present condition?
Probably a combination of her present right PCA infarct involving mainly
the inferior and medial temporal and occipital lobes (ie, lingual and/or medial occipitotemporal [fusiform] gyri), PLUS her prior left PCA infarct
6. In general, what pathologic process is involved in her most recent lesion?
Vascular – Right PCA infarct, involving the inferior and medial temporal
and occipital lobes (but not the calcarine cortex or primary visual cortex [area 17])
7. In general, what pathologic process is involved in all of the neurologic events that this patient has sustained?
Atherosclerotic vascular disease (medium and small vessel disease) due to
diabetes, hypertension, tobacco use
8. Are there additional diagnostic procedures that you would like to undertake at this point?
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