Gerstmann’s syndrome in a patient with left thalamic hemorrhage

ABSTRACT

A 78-year-old right-handed man presented with mild right hemiplegia and impaired deep sensation on his right side. He had no aphasia, but showed Gerstmann’s syndrome which is characterized by four primary symptoms fi nger agnosia, right-left disorientation, agraphia, and acalculia. A cranial CT revealed hemorrhagic lesions in the left thalamus, and single photon emission CT showed decreased regional cerebral blood fl ow in the superior portion of the left temporoparietal lobe, especially angular gyrus area. It is infered that in this case, corticofugal fi bers from the thalamus to the parietal lobe had been damaged by hemorrhage, secondarily causing decreased function of the cerebral cortex.