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Frontal signs following subcortical infarction
A J Corbett1, H Bennett, S Kos
1Department of Neurology, Repatriation General Hospital, Concord, NSW.
Clinical and Experimental Neurology
|January 1, 1992
Summary
Multiple subcortical cerebral infarcts in patients are linked to frontal lobe dysfunction and cognitive impairments. Physical signs like snout and grasp reflexes correlate with lesion severity and brain changes.
Area of Science:
- Neurology
- Neuroscience
- Radiology
Background:
- Subcortical cerebral infarction is associated with cognitive deficits, particularly those sensitive to frontal lobe damage.
- Frontal lobe dysfunction can manifest as specific physical signs.
Purpose of the Study:
- To investigate the association between physical signs of frontal lobe dysfunction and neuroimaging findings in patients with multiple subcortical cerebral infarcts.
- To determine if specific physical signs correlate with the extent and characteristics of subcortical infarcts.
Main Methods:
- A cohort of 82 patients with multiple subcortical cerebral infarcts (diagnosed via CT scan) was assessed.
- Physical examinations were performed to elicit signs presumed sensitive to frontal lobe dysfunction, including snout reflex, grasp reflex, and gait impairment.
- Associations between these physical findings and CT scan features (number of lesions, periventricular lucency, ventricular enlargement) were analyzed.
Main Results:
- The snout reflex was present in 38 patients and significantly correlated with the number of lesions, periventricular lucency, and ventricular enlargement.
- The grasp reflex occurred in 33 patients and correlated with the number of lesions and ventricular enlargement.
- Gait impairment was observed in 54 patients and correlated with the number of lesions and ventricular enlargement.
Conclusions:
- Multiple subcortical infarcts likely disrupt frontal association pathways, leading to frontal disconnection.
- This disruption results in observable frontal cognitive dysfunction and characteristic frontal release signs.
- The study establishes a link between specific physical signs and the neuroimaging evidence of subcortical infarcts, supporting the concept of frontal disconnection syndrome.