Kim M H, Hong S B, Roh J K
Department of Neurology, College of Medicine, Seoul National University, Korea.
J Korean Med Sci. 1994 Oct;9(5):427-31. doi: 10.3346/jkms.1994.9.5.427.
We report a 61-year-old right-handed man developing disturbance of memory after a discrete thalamic infarction. Neuropsychological assessment revealed deficits in memory with retrograde and anterograde components, especially for verbal material. Brain MRI showed a left anterior thalamic infarction with normal angiographic findings. Despite the small lesion in the thalamus, he showed prolonged memory disturbance and a Brain SPECT image revealed decreased uptake in the ipsilateral fronto-temporo-parietal cortex and contralateral cerebellum. This diaschisis, a phenomenon caused by disconnection of the neural pathway helped us to evaluate the functional state of the patient and this imaging technique was valuable for obtaining to get more information for the evaluation of the neurological state and neuronal connections. In conclusion our findings correspond well with the understanding of amnesia as a disconnection syndrome because of the evidence of diaschisis on the Brain SPECT image.
我们报告了一名61岁的右利手男性,在发生局限性丘脑梗死后出现记忆障碍。神经心理学评估显示存在逆行性和顺行性记忆缺陷,尤其是对言语材料的记忆。脑部MRI显示左侧丘脑前部梗死,血管造影结果正常。尽管丘脑病变较小,但他仍表现出长期的记忆障碍,脑部单光子发射计算机断层扫描(SPECT)图像显示同侧额颞顶叶皮质和对侧小脑摄取减少。这种失联络现象,即由神经通路断开引起的一种现象,有助于我们评估患者的功能状态,并且这种成像技术对于获取更多评估神经状态和神经元连接的信息很有价值。总之,由于脑部SPECT图像上存在失联络的证据,我们的发现与将失忆理解为一种断连综合征的观点非常吻合。