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[Gustatory disturbance associated with putaminal hemorrhage]
Akiko Imamura1, Tomohiko Kusuhara, Masasi Nakajima
15th Department (Neurology) of Internal Medicine, Fukuoka University School of Medicine.
Rinsho Shinkeigaku = Clinical Neurology
|April 19, 2003
Summary
A right putaminal hemorrhage caused a man's taste loss, dysarthria, and dysphagia. While speech and swallowing improved, persistent gustatory disturbance suggests central pathway damage in the pons and insular cortex.
Area of Science:
- Neuroscience
- Neurology
- Neuroimaging
Background:
- Sudden onset neurological deficits, including taste disturbance, dysarthria, and dysphagia, can indicate acute brain injury.
- Hemorrhagic stroke, particularly in the basal ganglia, requires prompt diagnosis and understanding of potential secondary effects.
Observation:
- A 48-year-old male presented with acute loss of taste, dysarthria, and dysphagia.
- Clinical examination revealed a severely elevated taste threshold.
- Neuroimaging identified a right putaminal hemorrhage with associated cerebral infarcts in the basal ganglia, corona radiata, and pons.
Findings:
- The patient's dysarthria and dysphagia resolved within two weeks, attributed to the regression of edema affecting bilateral cortico-bulbar tracts.
- Persistent gustatory disturbance was linked to the interruption of central gustatory pathways at the pons and subcortically near the insular cortex.
Implications:
- This case highlights the complex relationship between basal ganglia hemorrhage, pontine lesions, and gustatory pathway disruption.
- Understanding the specific neuroanatomical correlates of taste disturbances is crucial for accurate diagnosis and prognosis in stroke patients.
- Neuroimaging plays a vital role in elucidating the mechanisms underlying diverse neurological symptoms following cerebrovascular events.