02 January 2005 : Original article
Frontal lobe dysfunction secondary mania and dementia syndrome following right posterior cerebral artery territory infarction
Nages Nagaratnam, Kujan NagaratnamCase Rep Clin Pract Rev 2005; 6:35-40 :: ID: 16406
Abstract
Summary
Background: The clinical manifestations of an acute stroke could be well circumscribed and or widespread producing a number of variants. The clinical features could be diverse and complex depending
on the site, extent and location of the lesion. The possibility of frontal lobe disorder (or extensive behavioural dysfunction) in posterior cerebral artery territory infarction has often been overlooked
in most reports, probably because it does not fit well with the fact that the frontal lobe is typically spared in posterior cerebral artery infarction.
Case Report: This case study is about a 78- year- old right- handed man previously well who suffered a right posterior cerebral artery infarction. The first presenting symptoms were confusion, subtle weakness of the left side and contra- lateral homonymous hemianopia. This was followed a few days later by complex visual and auditory hallucinations, complex motor behaviour (environmental driven responses and utilization behaviours), disinhibition, aspontaniety, marked perseveration and visual agnosias for objects, colours and faces. At six months post-stroke he demonstrated aggressive and hostile behavior, restlessness and slept poorly consistent with mania and had memory problems. There are several lines of evidence to suggest the findings could be explained as an attentional disorder. The neuropsychological features declined over a period of 14 months from mild to severe dementia. The MRI showed involvement of the right temporo-occipital regions involving
the hippocampus, mesial temporal regions and extending to involve the thalamus and the retrospenial cortex.
Conclusions: The frontal-subcortical circuitry and the frontal diencephalic brain stem system provide a comprehensive framework for the understanding of the varied and complex neuropsychological
and neurobehavioral features associated with posterior cerebral artery infarction.
Keywords: Posterior cerebral artery infarction, frontal-subcortical circuitry, frontal diencephalic brain stem system, secondary mania
74
In Press
28 Mar 2024 : Original article
Association Between FEV₁ Decline Rate and Mortality in Long-Term Follow-Up of a 21-Patient Pilot Clinical T...Ann Transplant In Press; DOI: 10.12659/AOT.942823
02 Apr 2024 : Original article
Liver Transplantation from Brain-Dead Donors with Hepatitis B or C in South Korea: A 2014-2020 Korean Organ...Ann Transplant In Press; DOI: 10.12659/AOT.943588
02 Apr 2024 : Original article
Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...Ann Transplant In Press; DOI: 10.12659/AOT.943281
03 Apr 2024 : Review article
Alternative Therapies in Transplantology as a Promising Perspective in MedicineAnn Transplant In Press; DOI: 10.12659/AOT.943387
Most Viewed Current Articles
05 Apr 2022 : Original article
Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver TransplantationDOI :10.12659/AOT.935604
Ann Transplant 2022; 27:e935604
12 Jan 2022 : Original article
Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...DOI :10.12659/AOT.934738
Ann Transplant 2022; 27:e934738
22 Nov 2022 : Original article
Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...DOI :10.12659/AOT.937988
Ann Transplant 2022; 27:e937988
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860