Brescian Natalie E, Curiel Rosie E, Gass Carlton S
a Psychology Service, Eastern Colorado Veterans Affairs Healthcare System , Pueblo , CO , USA.
Neurocase. 2014;20(6):606-14. doi: 10.1080/13554794.2013.826690. Epub 2013 Aug 21.
This is a case study of an 88-year-old man who presented with agenesis of the corpus callosum and colpocephaly. Symptomatically, he reported a sudden onset of mild, intermittent left hand apraxia, but denied any previous manifestations consistent with this type of brain malformation. The patient underwent neuroimaging, evaluation by neurology, and comprehensive neuropsychological testing to determine the nature of any other associated impairments. Test results indicated that he was, with a few exceptions, neuropsychologically normal. He performed well on tests that are highly sensitive to acquired brain dysfunction. His most notable deficit was failed performance in the simultaneous and coordinated use of both hands in using tactile and proprioceptive feedback on the Tactual Performance Test. This case is discussed in terms of plasticity of the developing brain, including compensatory mechanisms, highlighting the variability in clinical outcome in the context of congenital brain malformation. This case study illustrates the strong influence of cerebral plasticity as well as a possible circumscribed manifestation of interhemispheric disconnection.
这是一个关于一名88岁男性的病例研究，该患者表现为胼胝体发育不全和脑室后角扩大。症状方面，他报告称突然出现轻度、间歇性左手失用症，但否认此前有任何与此类脑畸形相符的表现。患者接受了神经影像学检查、神经科评估以及全面的神经心理学测试，以确定是否存在任何其他相关损伤。测试结果表明，除了少数例外情况，他在神经心理学方面是正常的。他在对后天性脑功能障碍高度敏感的测试中表现良好。他最明显的缺陷是在触觉操作测试中，双手同时协调使用触觉和本体感觉反馈时表现不佳。本文从发育中大脑的可塑性角度，包括补偿机制，对该病例进行了讨论，强调了先天性脑畸形情况下临床结果的变异性。本病例研究说明了大脑可塑性的强大影响以及半球间连接中断可能出现的局限性表现。
