# Prosopagnosia Due to Metastatic Brain Tumor: A Case-Based Review

## TL;DR

This paper presents a rare case of acquired prosopagnosia caused by a brain tumor and highlights the effectiveness of conservative treatment.

## Contribution

The novelty lies in the rare presentation of prosopagnosia due to metastatic brain tumor and successful conservative treatment.

## Key findings

- A 69-year-old patient with rectal carcinoma cerebral metastases developed prosopagnosia.
- Conservative treatment with corticosteroids and osmotherapy successfully resolved the prosopagnosia.
- Brain lesions in the right cerebellar hemisphere compressed the ILF, causing the cognitive deficit.

## Abstract

Prosopagnosia, also referred to as “face blindness,” is a type of visual agnosia characterized by a decreased capacity to recognize familiar faces with a preserved ability to identify individuals based on non-facial visual traits or voice. Prosopagnosia can be categorized as developmental (DP) or acquired (AP) owing to a variety of underlying conditions, including trauma, neurodegenerative diseases, stroke, neuroinfections, and, less frequently, malignancies. Facial recognition is a complex process in which different neuronal networks are involved. The infrequent but notable higher visual-processing abnormalities can be caused by lesions of the inferior longitudinal fasciculus (ILF) in the non-dominant temporal lobe. We report a rare case of AP in a 69-year-old patient who is right-hand dominant with rectal carcinoma cerebral metastases. The patient complained of dizziness, vertigo, falls, and trouble recognizing her family members’ faces. The CT scan of the head with contrast revealed two metastatic brain lesions with vasogenic edema, as one of them was in the right cerebellar hemisphere, causing dislocation and compression of the ILF. Corticosteroids and osmotherapy were utilized as a conservative treatment approach, which resulted in the prosopagnosia being completely withdrawn. In conclusion, patients with primary brain tumors or metastatic disease rarely present with an isolated cognitive deficit such as prosopagnosia. Based on the anatomical features and the personalized approach, a conservative or surgical approach may be useful to improve higher cortical functioning.