Jović N, Vranjesević D, Nagulić M
Srp Arh Celok Lek. 1995 Jan-Feb;123(1-2):38-41.
We report on a 12-years-old boy with glioma of the septum pellucidum which invaded and infiltrated the adjacent structures including neocortical commissures. Neuropsychological evaluation revealed the loss of interhemispheric integration and hemisphere dysconnection syndrome. Our patient demonstrated left-sided ideo-motor apraxia to verbal commands and left-sided agrafia, being unable to copy, write to dictation and formulate his own sentences with the left hand. He partly failed in attempts to name or describe objects out of sight in the left hand and showing an unilateral tactile anomia. The patient performed the block-design-test better with the left hand than the right hand, and demonstrated a right-sided constructive apraxia. He had extinction of his left ear on dichotic listening, despite a normal audiogram in both ears. Because of progressive defects of visual function, a tachistoscoping testing was not performed. There was no evidence of the alien hand syndrome, reported earlier. The general dysconnection syndrome caused by lesion of the corpus callosum, was associated with cognitive dysfunctions. Attention, memory and speech disorders were attributed to the progressive extra-callosal cerebral neoplastic lesion. The neurosurgical treatment was performed by transcallosal anterior approach. On neuropsychological retesting, 4 months later symptoms of hemisphere dysconnection were stabilized.
我们报告了一名12岁患有透明隔胶质瘤的男孩,该肿瘤侵犯并浸润了包括新皮质连合纤维在内的相邻结构。神经心理学评估显示半球间整合功能丧失及半球分离综合征。我们的患者表现出对言语指令的左侧观念运动性失用症和左侧失写症,无法用左手临摹、听写和组织自己的句子。他在尝试说出或描述左手看不见的物体时部分失败,并表现出单侧触觉性命名障碍。患者左手执行积木设计测试比右手更好,并表现出右侧结构性失用症。他在双耳分听时左耳存在消退现象,尽管双耳听力图正常。由于视觉功能逐渐减退,未进行速示器测试。没有证据表明存在先前报道的异己手综合征。由胼胝体病变引起的一般分离综合征与认知功能障碍有关。注意力、记忆和言语障碍归因于进行性胼胝体外脑肿瘤病变。通过经胼胝体前入路进行了神经外科治疗。4个月后神经心理学复测时,半球分离症状稳定。