Degos J D, Gray F, Louarn F, Ansquer J C, Poirier J, Barbizet J
Departement de Neurosciences, CHU Henri Mondor, Creteil, France.
Brain. 1987 Oct;110 ( Pt 5):1155-71. doi: 10.1093/brain/110.5.1155.
Clinicoanatomical observations on a patient with partial interhemispheric disconnection associated with complete ischaemic destruction of the splenium and of the posterior part of the body of the corpus callosum are presented. Neuropathological examination of the areas containing degenerated white matter indicated that the lesions affected the transcallosal fibres that link the cortex of the occipital lobes and the superior parietal lobules (SPL). The white matter situated in the temporal lobes was intact. This suggests that in man, and contrary to what has been described in the monkey, the callosal pathway followed by the temporal fibres is rostral to the one followed by the parietal or at least by the SPL fibres. The most prominent disconnection syndrome elements were left tactile anomia (in spite of a rather good tactile-motor integration between the hemispheres), left visual anomia, agraphia of the left hand and 'diagnostic' apraxia. The fact that the anterior part of the corpus callosum was intact accounts for the preservation of interhemispheric transfer of somatic sensory information and for the absence of left extinction during the dichotic listening test. An attempt is made to give a more detailed explanation of the results obtained during the different tests.
本文呈现了对一名患者的临床解剖学观察结果，该患者存在部分大脑半球间分离，同时伴有胼胝体压部及胼胝体膝部后部完全缺血性破坏。对包含变性白质区域的神经病理学检查表明，病变影响了连接枕叶皮质和顶上小叶（SPL）的胼胝体纤维。颞叶中的白质未受影响。这表明在人类中，与猴子的情况相反，颞叶纤维所走行的胼胝体通路位于顶叶纤维（至少是顶上小叶纤维）所走行通路的前方。最显著的分离综合征表现为左侧触觉失认（尽管半球间触觉运动整合相当良好）、左侧视觉失认、左手失写症和“诊断性”失用症。胼胝体前部完好这一事实解释了躯体感觉信息半球间传递得以保留以及在双耳分听测试中左侧无消退现象的原因。本文尝试对不同测试中获得的结果给出更详细的解释。
