A Case of Isolated Traumatic Caudate Lesion with Marked Improvement in Visuospatial Function by Donepezil

Visuospatial dysfunction after isolated caudate lesion and improvement by donepezil has not been reported. Herein we report a 46-year old woman with visuospatial dysfunction after an isolated traumatic caudate lesion. Memory impairment and visuospatial dysfunction with normal frontal executive functioning was found in the first neuropsychological test. Her brain MRI showed an isolated right caudate lesion in the dorsal portion. Donepezil was prescribed. On follow-up neuropsychological testing, memory and visuospatial function increased by more than 100% from the base line.

Clinical Characteristics of Nonagenarian Stroke

BACKGROUND: As the elderly population is fast growing, the incidence of stroke is also increasing. We studied the clinical characteristics of nonagenarian stroke compared to a population of patients under the age of ninety. METHODS: Subjects included 44 nonagenarian stroke patients and 22,227 control patients aged under ninety. Clinical characteristics including age, sex, risk factors, stroke subtype, and outcome (one-year prognosis, evaluated by a modified Rankin scale) were analyzed. RESULTS: The proportion of nonagenarian stroke accounted for 0.2% of all cases of stroke. Ischemic stroke was more common than hemorrhagic stroke in the nonagenarian group. In addition, the female gender was more frequent (p<0.01). As the patients were older, their admission period was shorter, the discharge against medical advice was increased, and the mortality was higher. Hypertension and atrial fibrillation were significantly higher (p<0.05, p<0.001, respectively) in the nonagenarian ischemic stroke patients. CONCLUSIONS: Nonagenarian stroke patients have unique clinical characteristics compared with stroke patients under the age of ninety.