RESUMEN
When the frontal lobe of the brain is affected important behavioral changes may occur mainly at the level of executive functioning, i.e., planning, decision-making, judgment and self-perception. However, the behavioral changes may be of different nature with marked indifference and apathy. We report a clinical case of an 81-year-old patient with sudden onset of behavioral changes that were initially interpreted as an acute confusional episode of infectious etiology, but actually they were due to an ischemic lesion in the frontal lobe.
O lobo frontal, quando afetado, pode provocar alterações importantes do comportamento, principalmente na função executiva: planejamento, tomada de decisões, juízo e autopercepção. Contudo, as alterações podem ser de outra natureza, caracterizando-se por marcada indiferença e apatia. É relatado aqui o caso de uma paciente de 81 anos, com alterações súbitas do comportamento, que foram interpretadas inicialmente como um quadro confusional agudo de natureza infecciosa, mas que se mostraram provocadas por uma lesão isquêmica na região frontal.
Asunto(s)
Anciano de 80 o más Años , Femenino , Humanos , Isquemia Encefálica/complicaciones , Lóbulo Frontal/irrigación sanguínea , Enfermedades de Inicio Tardío/etiología , Trastornos Psicóticos/etiología , Isquemia Encefálica , Confusión/etiología , Trastornos del Humor/etiología , SíndromeAsunto(s)
Adulto , Humanos , Arterias Cerebrales/anatomía & histología , Venas Cerebrales/anatomía & histología , Lóbulo Frontal/cirugía , Microcirugia/métodos , Lóbulo Temporal/cirugía , Lóbulo Frontal/anatomía & histología , Lóbulo Frontal/irrigación sanguínea , Procedimientos Neuroquirúrgicos , Vías Olfatorias/irrigación sanguínea , Vías Olfatorias/cirugía , Lóbulo Temporal/anatomía & histología , Lóbulo Temporal/irrigación sanguíneaRESUMEN
Clinical, radiological and pathological studies in patients with stroke, presenting with pathological laughter as heralding manifestation, have shown lesions in the internal capsule and thalamus, basal ganglion, hypothalamus and ventral pons. In this report a patient with similar manifestation and having a cortical infarct in the territory supplied by superior division of middle cerebral artery is being presented. Our case suggests possible influence of dominant cerebral hemisphere, especially of Broca's area, on the motor control of laughter.