Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia E-mail:
Neurosciences (Riyadh). 2020 Oct;25(5):412-415. doi: 10.17712/nsj.2020.5.20200071.
The authors report a previously healthy 23-year-old male patient who presented with subarachnoid hemorrhage and was found to have a ruptured right distal anterior cerebral artery aneurysm. He was treated by endovascular coiling technique, which was uneventful perioperatively. After a few days of mechanical ventilation and upon extubation, he expressed symptoms of apathy, drowsiness, lack of motivation, and lack of spontaneous motor function consistent with akinetic mutism. The magnetic resonance imaging of the brain revealed infarction of the whole body of corpus callosum. He remained in akinetic mutism status for twenty-one days before he started to show improvement until he fully recovered in 3 months. The authors report a unique finding where akinetic mutism resulted from infarction of the corpus callosum rather than medial frontal lobe (cingulate gyrus).
作者报告了一例既往健康的 23 岁男性患者,因蛛网膜下腔出血就诊,发现右侧大脑前动脉远端破裂性动脉瘤。患者接受了血管内弹簧圈栓塞治疗,手术过程顺利。几天后,患者在接受机械通气并拔管后出现冷漠、嗜睡、缺乏动力和自发性运动功能丧失等症状,符合无动性缄默症的表现。脑磁共振成像显示胼胝体体部梗死。患者持续无动性缄默状态 21 天后开始好转,3 个月后完全康复。作者报告了一个独特的发现,即无动性缄默症是由胼胝体梗死引起的,而不是内侧额叶(扣带回)。