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[Vol.20 No.3 contents]
Japanese/English
Full Text of this Articlein Japanese PDF (124K) |
| ArticleTitle | Brain infarction and neuropsychology |
| Language | J |
| AuthorList | Yoichiro Hashimoto1), Kiminobu Yonemura2), Yuichiro Inatomi3), Teruyuki Hirano4), Makoto Uchino4) |
| Affiliation |
1) Department of Neurology, Kumamoto City Hospital 2) Department of Strokology, Kumamoto City Hospital 3) Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital 4) Department of Neurology, Graduate School of Medical Sciences, Kumamoto University |
| Publication | Japanese Journal of Neuropsychology: 20 (3), 195-206, 2004 |
| Received | |
| Accepted | |
| Abstract |
Brain infarction is classified by the mechanisms (thrombotic, embolic, hemodynamic), the clinical categories (atherothrombotic, cardioembolic, lacunar and other), the symptoms and signs by site (distribution) (NINDS, 1990). Lacunar brain infarction is caused by the occlusion of single perforating artery followed by lesion less than 15 mm. Lacunar strokes do not show consciousness disturbance, neuropsychological sign including aphasia, apraxia, agnosia, memory disturbance, and convulsion, monoparesis. The patients with neuropsychological sing are diagnosed as atherothrombotic or cardioembolic brain infarction. But thalamic infarctions sometimes show aphasia, memory disturbance, or rarely anosognosia. Donnan et al proposed classification of subcortical infarction, in which subcortical infarctions are composed of lacunar infarcts, striatocapsular infarcts, internal borderzone infarcts, anterior choroidal infarcts, thalamic infarcts, white matter medullary infarcts, extended large subcortical infarcts, and leukoaraiosis. In Cardioembolic brain infarctions, the prognosis of the aphasic patients due to larger infarction will be poor than smaller infarct. The other side, there are aphasic patients with poor prognosis due to smaller infarct as well as larger infarct in atherothrombotic infarctions. Global aphasia without hemiparesis has been regarded as a sign of embolic encephalopathy, but we had a patient by thrombotic occlusion. In acute stage, neuropsychological symptoms and signs are needed for diagnosis and treatment for stroke, therefore we should search for neuropsychological sign in spite of the presence of consciousness disturbance in acute stage. |
| Keywords | neuropsychological sign, brain infarction, clinical category, lacunar brain infarction, halamic infarction |
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