Alexia without agraphia is most specifically associated with infarction of which artery?

• A. Anterior cerebral artery infarction
• B. Middle cerebral artery infarction
• C. Posterior cerebral artery infarction
• D. Basilar artery infarction

Answer: (C)

Alexia without agraphia occurs when the left occipitotemporal region that houses the visual word form area is damaged, typically from a left posterior cerebral artery infarct. This area translates visual input into recognizable written words. When it’s disrupted, reading ability fails while writing and language production remain intact, because the graphemic/motor pathways for writing are spared. The left PCA territory—often involving the fusiform gyrus and sometimes the splenium of the corpus callosum—causes this disconnection between seeing words and recognizing them, producing pure alexia. In contrast, infarcts in other arteries affect motor, language, or brainstem functions and don’t produce this selective reading deficit. Therefore, the artery most specifically linked to alexia without agraphia is the posterior cerebral artery.