Obi T, Bando M, Takeda K, Sakuta M
Department of Neurology, Japanese Red Cross Medical Center.
Rinsho Shinkeigaku. 1992 Apr;32(4):426-9.
A 59-year-old man was admitted to our hospital for his sudden-onset right hemianopsia. Thirty days after the onset, neuropsychological examination revealed obvious topographical disorientation and mild optic ataxia. Magnetic resonance imaging showed abnormal intensity area at the left medial parietooccipital region and left splenium of the corpus callosum. Although single photon emission CT showed uptake decrement in the left hemisphere, almost normal uptake was observed in the right hemisphere. He could recognize landmarks, but fail to recognize the relative position of landmarks. Therefore, his topographical disorientation was considered to be due to perceptual disturbance, memory disturbance of relative position of landmarks, or both. He was right-handed with no sinistral relative, and showed dyslexia and dysgraphia early in his clinical course. The laterality index of the dichotic listening test revealed the right ear dominance. These results indicated that his left hemisphere was language dominant. His topographical disorientation could be caused by the medial parieto-occipital lesion in the dominant hemisphere.
一名59岁男性因突发右侧偏盲入院。发病30天后，神经心理学检查发现明显的地形定向障碍和轻度视性共济失调。磁共振成像显示左侧顶枕叶内侧区域和胼胝体压部有异常信号区。尽管单光子发射计算机断层扫描显示左侧半球摄取减少，但右侧半球摄取几乎正常。他能识别地标，但无法识别地标之间的相对位置。因此，他的地形定向障碍被认为是由于感知障碍、地标相对位置的记忆障碍或两者兼而有之。他是右利手，没有左利手亲属，并且在病程早期就出现了阅读障碍和书写障碍。双耳分听测试的利手指数显示右耳优势。这些结果表明他的左侧半球是语言优势半球。他的地形定向障碍可能是由优势半球的顶枕叶内侧病变引起的。
