Wang P Y
Department of Internal Medicine, Veterans General Hospital, Taichung, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1991 Mar;47(3):199-203.
A case of left caudate infarct with its associated neurobehavioral changes is reported with review of literature. The patient showed apathy, decreased problem solving ability, impaired memory and abstract thinking, especially the verbal memory. Such behavioral and cognitive changes correspond to disturbances of specific prefrontal-caudate circuits, either dorsolateral prefrontal or lateral orbitofrontal circuits. From review of literature, it is known that patients with dorsolateral caudate involvement may show apathy, reduced spontaneity and initiative; Patients with ventromedial caudate involvement will exhibit disinhibition, disorganization and impulsiveness, and patients with larger caudate lesion may show affective symptoms with psychotic features.
本文报告了一例左尾状核梗死及其相关神经行为变化的病例，并对文献进行了综述。患者表现出冷漠、解决问题能力下降、记忆力和抽象思维受损，尤其是言语记忆。这些行为和认知变化与特定的前额叶-尾状核回路紊乱相对应，即背外侧前额叶回路或外侧眶额回路。从文献综述可知，背外侧尾状核受累的患者可能表现出冷漠、自发性和主动性降低；腹内侧尾状核受累的患者会表现出脱抑制、紊乱和冲动，而尾状核病变较大的患者可能表现出伴有精神病特征的情感症状。
