Weidenfeld J, Finkelstein Y, Bental E
Department of Neurology, Rambam Medical Center, Haifa, Israel.
Acta Neurochir (Wien). 1988;90(1-2):67-9. doi: 10.1007/BF01541269.
Three unusual cases with astereognosis caused by cervical meningioma are presented. Astereognosis of subcortical origin has been reported several times. According to these reports, the causative lesion was confined to the area extending between the lower brain stem and the fourth cervical vertebra, thus suggesting that a sensory centre for stereognosis could be confined within these well defined anatomical limits, and that therefore a lesion in this area could lead to astereognosis. It is assumed in this paper that the lesion involves the sensory system of the Nucleus Cervicalis Lateralis. Fibres from the spinothalamic tract, a specialized sensory pathway, ascend from the palms of the hands to this nucleus. From this nucleus arise fibres which decussate and reach the Ventral Posterolateral Nucleus of the thalamus. It is likely that a lesion of the nucleus itself or its related sensory tracts may cause astereognosis.
本文报告了3例由颈段脑膜瘤引起实体觉丧失的罕见病例。皮质下起源的实体觉丧失已被多次报道。根据这些报道，致病病变局限于从延髓下部到第四颈椎之间的区域，因此提示实体觉的感觉中枢可能局限于这些明确界定的解剖范围内，并且该区域的病变可能导致实体觉丧失。本文推测该病变累及外侧颈核的感觉系统。来自特殊感觉通路脊髓丘脑束的纤维从手掌向上延伸至该核。从这个核发出的纤维交叉并到达丘脑腹后外侧核。很可能该核本身或其相关感觉束的病变可能导致实体觉丧失。
