Given a 70-year-old patient with left-side neglect, anosognosia, and visuospatial problems, with good auditory comprehension and repetition but difficulties with topic maintenance, the diagnostic classification most consistent is?

• A. Wernicke's aphasia
• B. Conduction aphasia
• C. Cognitive-communicative disorder consistent with right hemisphere damage
• D. Cognitive-communicative disorder consistent with left hemisphere damage

Answer: (C)

Left neglect, anosognosia, and visuospatial problems point to right-hemisphere involvement. When the right hemisphere is damaged, people often keep basic language skills intact—auditory comprehension and repetition can be good—while higher-level communication and discourse are affected. Difficulty with topic maintenance reflects a cognitive-communication issue rather than a primary language impairment, which fits right-hemisphere dysfunction. Wernicke’s aphasia would typically bring poor comprehension, and conduction aphasia would usually involve impaired repetition, which isn’t the case here. Left-hemisphere damage tends to produce clear language deficits plus fewer signs like neglect or anosognosia. So the pattern best matches a cognitive-communicative disorder associated with right hemisphere damage.