[A case of pure anarithmetia associated with disability in processing of abstract spatial relationship]

A 35-year-old right handed man developed pure anarithmetia after an left parieto-occipital subcortical hemorrhage. His intelligence, memory, language, and construction ability were all within normal limits. No hemispatial neglect, agraphia, finger agnosia, or right-left disorientation were noted. He showed no impairments in reading numbers aloud, pointing to written numbers, writing numbers to dictation, decomposition of numbers, estimation of numbers of dots, reading and writing of arithmetic signs, comprehension of arithmetic signs, appreciation of number values, appreciation of dots' number, counting aloud, alignment numbers, comprehension of the commulative law and the distributive law, retrieval of the table value (ku-ku), immediate memory for arithmetic problems, and use of electric calculator. He showed, however, remarkable difficulty even in addition and subtraction between one figure digits, and used counting on his fingers or intuitive strategy to solve the problems even when he could solve them. He could not execute multiplication and division, if the problems required other than the table value (ku-ku). Thus, he seemed to have difficulties in both of elemental arithmetic facts and calculating procedures. In addition, his backward digit span and reading of analogue clocks were deteriorated, and he showed logico-grammatical disorder of Luria. Our case supports the notion that there is a neural system which was shared in part between processing of abstract spatial relationship and calculation.