Long-lasting topographical disorientation in new environments

We describe the case of a young woman with long-lasting topographical disorientation following a haemorrhagic lesion of the right temporo-occipital region involving the hippocampus. She was unable to orient herself in novel environments and to perform learning spatial tasks both in real-world settings and laboratory conditions. Her ability to recall and navigate through known routes as well as to recognize familiar landmarks was preserved. Neuropsychological evaluation revealed a mild long-term memory deficit. A similar neuropsychological and experimental pattern was observed 8 years later (at the time of follow-up) when she showed a persistent topographical disorientation and a slight worsening of verbal and visuospatial long-term memory disorders. Her topographical disorientation was characterized by an impairment confined to the anterograde memory domain, a not frequent pattern reported in literature, in the absence of remote topographical memory disorders. The presence of a lesion localized in the right occipito-temporal region and hippocampus combined with the results observed in some experimental tasks could also contribute to the debate of the role of neural correlates involved in topographical spatial knowledge. (c) 2008 Elsevier B.V. All rights reserved.