Mrabet A, Mrad-Ben Hammouda I, Abroug Z, Smiri W, Haddad A
Service de neurologie, Hôpital Charles Nicolle, Tunis, Tunisie.
Rev Neurol (Paris). 1994;150(1):67-9.
We report the case of a 57-year-old right-handed woman, with a history of hypertension, who, in February 1990, suddenly developed behavioral and cognitive abnormalities. Prior to the onset of her illness she had been normal. On examination, neuropsychological testing (Wechsler Mental Test, Wechsler Adult Intelligence Scale Revised, Knox Cube Test) elicited attention abnormalities, decreased recent memory, apathy, reduced spontaneity and initiative and left hemiparesia. CT scan showed small low density areas in the head of both caudate nuclei and right internal capsule, indicating infarction. Two years later, the deficit had partially resolved. Apathy persisted; psychometry showed an IQ of 57. Bilateral damage to the head of the caudate nuclei disrupt cortical-subcortical connections. The caudate nucleus is an essential component of basal ganglia-thalamo-cortical circuitry and its contribution to cognitive functions and behavior appears to be important.
我们报告了一例57岁的右利手女性病例，该患者有高血压病史，于1990年2月突然出现行为和认知异常。发病前她一切正常。经检查，神经心理学测试（韦氏心理测验、修订版韦氏成人智力量表、诺克斯方块测验）显示存在注意力异常、近期记忆力减退、冷漠、自发性和主动性降低以及左侧偏瘫。CT扫描显示双侧尾状核头部和右侧内囊有小的低密度区，提示梗死。两年后，缺损部分得到缓解。冷漠依然存在；心理测量显示智商为57。双侧尾状核头部受损破坏了皮质-皮质下连接。尾状核是基底神经节-丘脑-皮质环路的重要组成部分，其对认知功能和行为的作用似乎很重要。
