Neuropsychiatric symptoms in a occipito-temporal infarction with remarkable long-term functional recovery
| Autor: | Kaloyan S. Tanev, Alessandro Biffi, Khalid Hassan, Lydia E. Federico, Catherine L. Leveroni, Valerie J. Sydnor |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Photophobia Cognitive Neuroscience 05 social sciences Topographical disorientation Experimental and Cognitive Psychology medicine.disease 050105 experimental psychology 03 medical and health sciences 0302 clinical medicine Neuropsychology and Physiological Psychology Physical medicine and rehabilitation medicine 0501 psychology and cognitive sciences Cognitive rehabilitation therapy medicine.symptom Headaches Occipital lobe Psychology Stroke 030217 neurology & neurosurgery Executive dysfunction Black spot |
| Zdroj: | Cortex. 137:205-214 |
| ISSN: | 0010-9452 |
| DOI: | 10.1016/j.cortex.2021.01.013 |
| Popis: | Posterior circulation infarctions (PCI) constitute 5-25% of ischemic strokes. PCI of the occipital lobe present with a panoply of symptoms including quadrantanopsia, topographical disorientation, and executive dysfunction. Long-term cognitive recovery after PCI is not well described. However, the adult brain is remarkably plastic, capable of adapting and remodeling. We describe a 43-year-old right-handed woman who complained of black spots in both eyes, headaches, photophobia, and a feeling she would faint. Initial neurological exam and a CT scan were normal; she was diagnosed with ocular migraine. A second neurological exam a week later showed left superior quadrantopsia; an MRI scan suggested right occipito-temporal infarct. In subsequent months, the patient complained of fatigue, quadrantanopsia, memory problems, and topographical disorientation. The patient participated in multi-modality treatment, and in self-directed arts projects and physical activities. Six years later, she reported noticeable improvements in cognition and daily functioning, which were documented on neurocognitive testing. Comparison between initial and subsequent MRIs using FreeSurfer 5.3 identified neuroplastic brain changes in areas serving similar functions to the areas injured from the stroke. The case illustrates the neuropsychiatric presentation after right occipito-temporal stroke, the value of formal and self-directed cognitive rehabilitation, the extended time to cognitive recovery, and the ability of the brain to undergo neuroplastic changes. |
| Databáze: | OpenAIRE |
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