Doder M, Jahanshahi M, Turjanski N, Moseley I F, Lees A J
The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
J Neurol Neurosurg Psychiatry. 1999 Mar;66(3):380-5. doi: 10.1136/jnnp.66.3.380.
A 36 year old man, who sustained a skull fracture in 1984, was unconscious for 24 hours, and developed signs of Parkinson's syndrome 6 weeks after the injury. When assessed in 1995, neuroimaging disclosed a cerebral infarction due to trauma involving the left caudate and lenticular nucleus. Parkinson's syndrome was predominantly right sided, slowly progressive, and unresponsive to levodopa therapy. Reaction time tests showed slowness of movement initiation and execution with both hands, particularly the right. Recording of movement related cortical potentials suggested bilateral deficits in movement preparation. Neuropsychological assessment disclosed no evidence of major deficits on tests assessing executive function or working memory, with the exception of selective impairments on the Stroop and on a test of self ordered random number sequences. There was evidence of abulia. The results are discussed in relation to previous literature on basal ganglia lesions and the effects of damage to different points of the frontostriatal circuits.
一名36岁男性，1984年头部受伤导致颅骨骨折，昏迷24小时，伤后6周出现帕金森综合征症状。1995年接受评估时，神经影像学检查发现因创伤导致左侧尾状核和豆状核梗死。帕金森综合征主要表现为右侧，进展缓慢，对左旋多巴治疗无反应。反应时间测试显示双手尤其是右手在运动起始和执行方面缓慢。运动相关皮层电位记录提示运动准备存在双侧缺陷。神经心理学评估显示，在评估执行功能或工作记忆的测试中，除了在斯特鲁普测试和自定顺序随机数字序列测试中有选择性损伤外，没有明显缺陷的证据。有意志缺失的证据。本文结合以往关于基底神经节病变以及额纹状体回路不同部位损伤影响的文献对结果进行了讨论。
