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[Bilateral caudate head infarcts]

N Kuriyama1, Y Yamamoto, I Akiguchi

  • 1Department of Neurology, Kyoto Second Red Cross Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|March 21, 1998
PubMed
Summary
This summary is machine-generated.

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Bilateral caudate head infarcts, potentially from cardioembolism, can cause severe abulia and cognitive deficits. This case highlights the significant impact of these specific brain lesions.

Area of Science:

  • Neurology
  • Neuroimaging
  • Vascular Neurology

Background:

  • Caudate head infarcts are rare and can lead to significant neurological deficits.
  • Understanding the vascular supply to the medial striate arteries is crucial for diagnosing such conditions.

Observation:

  • A 67-year-old woman presented with sudden mutism and profound abulia following bilateral caudate head infarcts.
  • Clinical examination revealed apathy, psychomotor slowness, and deficits in spontaneous activity, speech, and attention.
  • Neuroimaging confirmed bilateral caudate head hemorrhagic infarcts extending into the anterior internal capsules, with the left lesion being more extensive.

Findings:

  • The infarcts were likely caused by cardioembolic occlusion affecting the medial striate arteries and Heubner's arteries.

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  • Asymptomatic right internal carotid artery occlusion was noted, along with cardiovascular risk factors including hypertension, diabetes, and atrial fibrillation.
  • Despite treatment and rehabilitation, the patient's condition did not improve, and she died a year later.
  • Implications:

    • Bilateral caudate head infarcts involving the anterior internal capsule can result in severe and persistent abulia.
    • This case underscores the importance of considering cardioembolic sources in patients with bilateral striatal infarcts.
    • Further research into the specific vascular territories and potential contributing anatomical variations is warranted.