Amusia for pitch caused by right middle cerebral artery infarct

A 61-year-old right-handed man with hypertension and dyslipidemia noted that he was singing along to classic rock songs on his car radio, but his voice was off pitch. Six days later, a magnetic resonance imaging scan of his brain revealed a cerebral infarct of the right temporal parietal cortex and insula. Case reports of the precise anatomic correlates of disordered pitch musical processing have been few and fragmentary. The anatomic involvement of our case coincides with the areas of involvement in 3 previously reported cases. Increased awareness of amusia as a rare clinical presentation of stroke should lead to earlier stroke intervention.