Static Visual Agnosia Following Awake Resection of a Left Frontal Low-Grade Glioma: A Case Report of Ventral Stream Network Disruption ("Astatopsia")

Background and Clinical Significance: Visual agnosia and speech production deficits are well-described sequelae of neurosurgical interventions, but their selective dissociation remains rare. This report presents an unusual combination of postoperative deficits following awake resection of a left frontal low-grade glioma. Case Presentation: We present the case of a right-handed female with left hemisphere language dominance who had a left frontal low-grade glioma. Preoperatively, she exhibited anomia and dysexecutive syndrome, including difficulty completing everyday goal-directed tasks such as sending emails and paying for parking. Following awake tumor resection, she developed two rare, dissociated deficits: (1) speech restricted to infinitive verb forms and (2) selective visual agnosia for static images, with preserved recognition of dynamic stimuli. Conclusions: This uncommon clinical constellation highlights the vulnerability of left frontal language and ventral visual processing networks during surgery and supports the dual-stream model of vision and language production. We describe a selective form of static visual agnosia affecting static images with relative preservation of dynamic and object recognition, for which we use the descriptive label “astatopsia”. This peculiar clinical condition is rarely documented in this particular combination and has not, to the best of our knowledge, previously been denominated in such a manner in the literature.