Khanra Sourav, Paul Neelanjana, Mukherjee Swapan
Department of Psychiatry, ICARE Institute of Medical Sciences and Research, Haldia, West Bengal, India.
Department of Pediatric Neurology, Institute of Child Health, Kolkata, West Bengal, India.
Indian J Psychol Med. 2018 Jan-Feb;40(1):96-98. doi: 10.4103/IJPSYM.IJPSYM_116_17.
Clinical signs and symptoms of posterior cerebral artery (PCA) stroke are varied and can be challenging to diagnose at early stage. A case of bilateral PCA infarct presenting with marked behavioral symptoms and minimal neurological symptoms is presented here. A 34 years old female had presented with marked behavioral symptoms, blurring of vision and tingling sensation in left half of body. Though the latter complaints resolved following day, her behavioral complaints persisted. Magnetic Resonance Imaging (MRI) of brain revealed acute non-hemorrhagic infarct in bilateral PCA territory. Psychotropics were beneficial for her behavioral symptoms. Isolated behavioral symptoms in PCA stroke led to speculate anatomical substrate for those symptoms. We discussed possible anatomical substrates for behavioral symptoms. Our case adds to the existing literature on a range of disguising presentations in PCA stroke and also emphasizes those distinctions between 'neurological' or 'psychological' or 'psychiatric' disorders are often sketchy.
大脑后动脉（PCA）卒中的临床体征和症状多种多样，早期诊断具有挑战性。本文介绍了一例双侧PCA梗死患者，该患者表现出明显的行为症状，而神经症状轻微。一名34岁女性出现明显的行为症状、视力模糊和身体左侧刺痛感。尽管后述症状在第二天有所缓解，但她的行为症状仍持续存在。脑部磁共振成像（MRI）显示双侧PCA区域急性非出血性梗死。精神药物对她的行为症状有益。PCA卒中中孤立的行为症状促使人们推测这些症状的解剖学基础。我们讨论了行为症状可能的解剖学基础。我们的病例增加了关于PCA卒中一系列伪装表现的现有文献，也强调了“神经”“心理”或“精神”障碍之间的区别往往并不明确。
