ABSTRACT
A 54-year-old, right-handed male suffered three sequential infarcts. The first two destroyed much of the right posterior parietal area, the posterior-medial portion of the right temporal lobe and virtually the entire right occipital lobe producing left homonymous hemianopsia and left visual neglect but no prosopagnosia. A third vascular accident involved the left parieto-occipital lobe and immediately produced prosopagnosia that has persisted. The sequential correlations of lesion and symptomatology in this case demonstrate that development of persistent prosopagnosia occurred only after bilateral damage.
Subject(s)
Agnosia/physiopathology , Cerebral Infarction/physiopathology , Dominance, Cerebral/physiology , Occipital Lobe/physiopathology , Agnosia/diagnosis , Agnosia/psychology , Cerebral Infarction/diagnosis , Cerebral Infarction/psychology , Humans , Mental Recall/physiology , Middle Aged , Neuropsychological Tests , Pattern Recognition, Visual/physiology , Psychomotor Performance/physiology , Tomography, X-Ray ComputedABSTRACT
The clinical spectrum of juvenile head trauma syndromes was derived from an analysis of 50 attacks in 25 patients. Attacks were grouped into four clinical types: (1) hemiparesis; (2) somnolence, irritability, and vomiting; (3) blindness; and (4) brain stem signs. Our evidence shows that these four types are different manifestations of a common underlying process. All attacks followed mild head trauma after a latent interval, generally of one to ten minutes. Forty of the 50 attacks occurred in patients under 14 years of age. Full recovery occurred after a variable time in all but one instance. This patient, and one other, had an angiographically demonstrable occlusion of a branch of the middle cerebral artery. In clinical and laboratory features, these attacks resemble classical migraine and presumably have a similar underlying mechanism.
