Corpus callosum infarction / 国际脑血管病杂志

The corpus callosum is the largest white matter tract in the human brain, and its specific function is still unclear. Corpus callosum infarction is clinically rare, and its manifestations are complex and diverse. It is easy to miss and misdiagnose early. Corpus callosum infarction is often accompanied by other parts infarction, and the incidence of the infarction at the splenium of corpus callosum is the highest. Isolated corpus callosum infarction can be characterized by typical disconnection symptoms, such as apraxia, tactile disorder, Alien hand syndrome, visual deformity, etc. The prognosis of the corpus callosum infarction is generally better. This article reviews the etiology, clinical manifestations, imaging, differential diagnosis, and research status of treatment of corpus callosum infarction.

Transient Gerstmann syndrome as manifestation of stroke: Case report and brief literature review / Síndrome de Gerstmann transitória como manifestação de acidente vascular encefálico: relato de caso e breve revisão de literatura

ABSTRACT Gerstmann Syndrome (GS) is a rare neurological condition described as a group of cognitive changes corresponding to a tetrad of symptoms comprising agraphia, acalculia, right-left disorientation and finger agnosia. It is known that some specific brain lesions may lead to such findings, particularly when there is impairment of the angular gyrus and adjacent structures. In addition, the possibility of disconnection syndrome should be considered in some cases. The purpose of this article is to report a case of a young, cardiac patient, non-adherent to treatment, who presented with a stroke in which transient clinical symptoms were compatible with the tetrad of GS. The case report is followed by a discussion and brief review of the relevant literature.

RESUMO A síndrome de Gerstmann (SG) é uma condição neurológica rara, caracterizada por um grupo de alterações cognitivas que correspondem a uma tétrade composta por agrafia, acalculia, desorientação direita-esquerda e agnosia para dedos. Sabe-se que certas lesões encefálicas específicas podem levar a tais achados, particularmente quando ocorre acometimento do giro angular e estruturas adjacentes. Além disso, a possibilidade de síndrome de desconexão deve ser considerada em alguns casos. O propósito deste artigo é relatar o caso de um paciente jovem cardiopata e não aderente ao tratamento que se apresentou com uma síndrome encéfalo-vascular associada a alterações clínicas transitórias compatíveis com a tétrade da SG. Este relato de caso é acompanhado de discussão e breve revisão de dados pertinentes da literatura.

Anton's Syndrome and Eugenics

Anton's syndrome is arguably the most striking form of anosognosia. Patients with this syndrome behave as if they can see despite their obvious blindness. Although best known for his description of asomatognosia and visual anosognosia, Gabriel Anton (1858-1933) made other significant contributions to the clinical neurosciences, including pioneering work in neurosurgery, neuropsychology, and child psychiatry. However, it has not been recognized in the English literature that Anton was also a dedicated advocate of eugenics and racial hygiene. This paper provides a case of Anton's syndrome and puts the works of Gabriel Anton into their historic context.

The Surgical Effect of Callosotomy in the Treatment of Intractable Seizure

We evaluated the surgical effects of the callosotomy, particularly with respect to the effect of callosotomy in some seizure types and the extent of surgery. Twenty-one patients with a minimum follow-up of two year were enrolled. The most significant effect of callosotomy was the complete suppression of the generalized seizures associated with drop attack in 12 of 21 patients and seizure reduction of more than 75% in 6 of 21 patients. The surgical effect on the partial seizures was very variable. Transient disconnection syndrome appeared in 4 patients after anterior callosotomy. Total callosotomy by staged operation significantly suppressed generalized seizures associated with drop attack without any disconnection syndrome. Our data show that callosotomy is quite a good approach to the surgical treatment of drop attacks accompanied by disabling generalized seizures.

Two Cases of Callosal Disconnection Syndrome: Impaired Body Cognition of Nondominant Limbs

Callosal disconnection results in the functional independence of each hemisphere and usually produces characteristic signs including alien hand, left-sided apraxia, left agraphia and left tactile anomia. Our two patients; a 75-year-old right-handed woman with hypertension and a 71-year-old right-handed woman with diabetes mellitus, showed impairments in the identification of body parts with their left hands in addition to characteristic symptoms such as left ideomotor apraxia, agraphia, tactile anomia, and right alien hand signs with groping and grasping. Brain MRIs of these patients upon admission demonstrated infarcts in the medial portion of the left frontal lobes and in the corpus callosum supplied by the left anterior cerebral artery. The impairment of body parts cognition in our patients can be attributed to the failure of the patient's left hand to communicate with the body schema stored in the left hemisphere.

Amnesia syndrome following left anterior thalamic infarction; with intrahemispheric and crossed cerebro-cerebellar diaschisis on brain SPECT

We report a 61-year-old right-handed man developing disturbance of memory after a discrete thalamic infarction. Neuropsychological assessment revealed deficits in memory with retrograde and anterograde components, especially for verbal material. Brain MRI showed a left anterior thalamic infarction with normal angiographic findings. Despite the small lesion in the thalamus, he showed prolonged memory disturbance and a Brain SPECT image revealed decreased uptake in the ipsilateral fronto-temporo-parietal cortex and contralateral cerebellum. This diaschisis, a phenomenon caused by disconnection of the neural pathway helped us to evaluate the functional state of the patient and this imaging technique was valuable for obtaining to get more information for the evaluation of the neurological state and neuronal connections. In conclusion our findings correspond well with the understanding of amnesia as a disconnection syndrome because of the evidence of diaschisis on the Brain SPECT image.