Bogousslavsky J, Miklossy J, Regli F, Deruaz J P, Assal G, Delaloye B
Neurology Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Ann Neurol. 1988 May;23(5):448-52. doi: 10.1002/ana.410230504.
In 2 patients with infarction in the territory of the right anterior choroidal artery, hemiparesis, hemihypesthesia (in 1), and hemianopia or superior quadrantanopia were associated with severe multimodal hemineglect, without anosognosia, disorientation, or asomatognosia. Single-photon emission tomography showed that marked hypoperfusion was not limited to the right posterior capsular region, but also involved the overlying parietal cortex, and to a lesser extent the frontal cortex. At autopsy in 1 patient, the infarct was nearly limited to the deep white matter of the temporal isthmus and the retrolenticular part of the internal capsule; only minute lesions were present in the globus pallidus, body of caudate, and amygdala. These findings are consistent with a disconnection phenomenon as the basis for subcortical neglect with ipsilateral deactivation of the parietofrontal cortex.
在2例右侧脉络膜前动脉供血区梗死患者中，偏瘫、偏身感觉减退（1例）以及偏盲或象限性上半盲与严重的多模式偏侧忽视相关，无疾病感缺失、定向障碍或自体部位失认。单光子发射断层扫描显示，明显的灌注不足不仅限于右侧后囊区，还累及上方的顶叶皮质，额叶皮质受累程度较轻。在1例患者尸检时，梗死几乎仅限于颞峡深部白质和内囊后肢；苍白球、尾状核体和杏仁核仅有微小病变。这些发现与一种分离现象一致，该现象是皮质下忽视伴同侧额顶叶皮质失活的基础。
