Shores A, Kraiuhin C, Zurynski Y, Singer A, Gordon E, Marosszeky J, Fearnside M R
Department of Nuclear Medicine, Westmead Hospital, NSW.
Aust N Z J Psychiatry. 1990 Mar;24(1):133-8. doi: 10.3109/00048679009062895.
A 43 year old man with a traumatic amnesic syndrome experienced only a brief, if any, loss of consciousness following an injury to the head. Four years after this injury, his results on standard psychometric assessment were normal. Long-latency evoked response potentials results were normal, and the neurological examination and computed tomography scans were unhelpful in explaining his amnesic symptoms. He had no history of alcohol abuse, yet his neuropsychological profile was that of a Korsakoff-like amnesia with frontal lobe features. Magnetic-resonance images demonstrated evidence of extensive frontal lobe damage, while cerebral blood flow studies provided additional evidence of bilateral frontal lobe dysfunction. The case highlights the need for those giving opinions in medico-legal head trauma cases to go beyond a reliance on routine indicators, such as duration of coma, results of standard psychometric assessment and computed tomography scans, to more specialised neuropsychological evaluations and magnetic-resonance imaging scans.
一名患有创伤性遗忘综合征的43岁男性在头部受伤后仅经历了短暂的意识丧失（即便有意识丧失的话）。受伤四年后，他在标准心理测量评估中的结果正常。长潜伏期诱发电位结果正常，神经学检查和计算机断层扫描无助于解释他的遗忘症状。他没有酗酒史，但其神经心理学特征却类似柯萨科夫样遗忘症并伴有额叶特征。磁共振成像显示有广泛额叶损伤的证据，而脑血流研究则进一步证明了双侧额叶功能障碍。该病例凸显了在法医头部创伤案件中发表意见的人员有必要超越对常规指标的依赖，如昏迷持续时间、标准心理测量评估结果和计算机断层扫描，转而进行更专业的神经心理学评估和磁共振成像扫描。
