A 68 year-old man presenting ideomotor apraxia and incomplete Gerstmann syndrome with multiple cystic lesions in the left hemisphere

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  • 左大脳半球に多発する嚢胞状病変をみとめ，観念運動性失行，不全型Gerstmann症候群を呈した68歳男性例
  • 左大脳半球に多発する囊胞状病変をみとめ,観念運動性失行,不全型Gerstmann症候群を呈した68歳男性例
  • ヒダリ ダイノウ ハンキュウ ニ タハツ スル ノウホウジョウ ビョウヘン オ ミトメ,カンネン ウンドウセイ シッコウ,フゼンガタ Gerstmann ショウコウグン オ テイシタ 68サイ ダンセイレイ

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Abstract

A 68-year-old man was referred to our hospital with tension-type headaches and a 1-year history of dementia. On neurologic examination, he had ideomotor apraxia and incomplete Gerstmann syndrome that was characterized by acalculia, agraphia, and finger agnosia. On imaging, multiple cystic lesions reported as "unusually dilated perivascular spaces" were observed along the medullary arteries in the left hemisphere; some of them had adjacent hyperintense areas in fluid attenuated inversion recovery images. We assumed that the multiple cystic lesions caused his higher cerebral dysfunction, because ideomotor apraxia and Gerstmann syndrome are usually indicative of a left parietal lobe lesion. MR spectroscopy in the lesion site revealed increased lactate. On MR angiography, the left middle cerebral artery and the left posterior cerebral artery were poorly visualized without localized stenosis. Technetium-99 bicisate single-photon emission computed tomography showed severely decreased cerebral blood flow in the left hemisphere. Electroencephalography showed slow waves in the left hemisphere.<br>

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 52 (9), 681-684, 2012

    Societas Neurologica Japonica

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