Crossed aphasia and apraxia in an artist

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Abstract
A 56-year-old right-handed male painter (OJH) was studied for three years post-stroke. The stroke had resulted in a large posterior right hemisphere infarction with initial left hemiparesis and sensory loss. The hemiparesis as well as initial signs of the left-sided neglect recovered, but he remained aphasic and apraxic. The findings show that praxis is not always controlled by the hemisphere contralateral to the dominant hand. The patient was studied with neuropsychological tests and experimental tasks. He showed no deficit in gesture, but generally poor non-verbal performances. He resumed painting very early after the stroke. Despite early signs of neglect his ability to paint recovered completely. His intact ability to paint is contrasted with initially average visuo-constructive test performance, poor abstract reasoning performance with visual designs, and poor sequencing ability in evaluating or constructing a pictorial narrative. The results are interpreted as indicating a complete reversal of the normal pattern of lateralized cerebral representation of function.