Department of Neurology, Kyung Hee Medical Center, School of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemoon-ku, Seoul 130 702, Korea.
J Clin Neurosci. 2011 Feb;18(2):203-8. doi: 10.1016/j.jocn.2010.05.026. Epub 2010 Dec 16.
Cognitive decline following posterior cerebral artery infarction (PCAI) is associated with lesions in the occipital lobe that extend into the parahippocampus or the splenium. We investigated patterns of neuropsychological deficits, including those causing executive dysfunction, associated with isolated lesions of the occipital lobe and with extensive lesions of the occipital lobe that extended into the splenium or the posterior ventral temporal lobes including the parahippocampus and fusiform gyrus. Eleven patients with unilateral PCAI involving the cerebral cortex and one patient with an occipital hemorrhage were selected for inclusion in this study. The mean age of the patients was 68.50 ± 7.94 years and their mean level of education was 8.58 ± 4.12 years. Four patients had isolated occipital lobe lesions and eight had lesions in either the splenium or the posterior ventral temporal lobe in addition to the occipital lobe. Whereas three of four patients with isolated occipital lobe lesions had left-sided lesions, only three of the eight patients with extended occipital lesions had left-sided lesions. The patients underwent a standardized battery of neuropsychological tests. The patients with occipital injuries in addition to splenial or posterior ventral temporal lobe injuries demonstrated performance decline across diverse cognitive domains, including memory (eight of eight), visuospatial function (eight of eight), executive function (seven of eight), language-related function (four of eight) and attention (one of eight). In contrast, memory impairment (three of four patients) was the only area in which patients with isolated occipital lobe lesions demonstrated decline in performance. Our findings suggest that strokes in the territory of the posterior cerebral artery are frequently associated with executive dysfunction. Injuries involving the splenium or posterior ventral temporal lobe in addition to the occipital lobe lead to more diverse neuropsychological impairments than do isolated occipital lobe injuries alone.
大脑后动脉梗死（posterior cerebral artery infarction，PCAI）后认知能力下降与枕叶病变有关，这些病变延伸至海马旁回或压部。我们研究了神经心理学缺陷的模式，包括导致执行功能障碍的缺陷，这些缺陷与孤立的枕叶病变以及广泛的枕叶病变有关，这些病变延伸至压部或后腹侧颞叶，包括海马旁回和梭状回。我们选择了 11 例单侧大脑后动脉梗死累及皮质的患者和 1 例枕叶出血的患者纳入本研究。患者的平均年龄为 68.50±7.94 岁，平均受教育年限为 8.58±4.12 年。4 例患者有孤立的枕叶病变，8 例患者除枕叶外，还有压部或后腹侧颞叶病变。虽然 4 例孤立的枕叶病变中有 3 例为左侧病变，但 8 例广泛的枕叶病变中仅有 3 例为左侧病变。患者接受了标准化的神经心理学测试。除了压部或后腹侧颞叶损伤外，还有枕叶损伤的患者在多种认知领域表现出认知能力下降，包括记忆（8/8）、视空间功能（8/8）、执行功能（7/8）、语言相关功能（4/8）和注意力（1/8）。相比之下，孤立的枕叶病变患者只有记忆损伤（4 例中有 3 例）出现了认知能力下降。我们的发现表明，大脑后动脉供血区的中风经常与执行功能障碍有关。除了枕叶之外，压部或后腹侧颞叶的损伤比孤立的枕叶损伤导致更多样化的神经心理学损伤。
