- 著者
- SAKO Rikitaro KATO Masaki MURAYAMA Takashi ENOKIDANI Takahiro OTA Takayuki HONDERA Tetsuichi FUJII Ami OZASA Yoshifumi
- 出版者
- 脳機能とリハビリテーション研究会
- 雑誌
- Journal of Rehabilitation Neurosciences (ISSN:24342629)
- 巻号頁・発行日
- vol.20, no.JPN, pp.49-55, 2020 (Released:2020-10-09)
Right-sided unilateral spatial neglect (USN) of patients with left hemisphere stroke disappears within a few months from the onset. Also, it has been reported that right-sided USN of bilateral hemisphere lesions patients persists even after 6 months from the onset. Herein, we present the case of a left middle cerebral artery stroke patient with persistent right-sided USN. The patient was right-handed female in her eighties. She was diagnosed with myelodysplastic syndrome 12 years before and then had severe anemia. She suffered from stroke and was hospitalized. She complained of severe right-sided hemiparesis, sensory disturbance, USN, and aphasia. During hospitalization, the laboratory tests revealed a hemoglobin level of 6.0 – 10.2 g/dL and hematocrit level of 18.3–31.8 %. She underwent rehabilitation for fatigue from the anemia. However, her right-sided hemiparesis and USN persisted, and on day 174 post onset she needed support for activities of daily living. Studies have reported that the persistence of the right-sided USN with left hemisphere lesions have a strong relationship with hypoperfusion in the left hemisphere and right parietal regions, even if the right hemisphere has no lesion at all. The decrease in the bilateral hemisphere function is known to hinder the improvement of right-sided USN. Severe anemia (hematocrit level 21.0 %) has also been reported to decrease the oxygen metabolism of whole brain cortex. From these studies severe anemia was thought to hinder the improvement of right-sided USN.
- 著者
- Ota Takayuki Yamamoto Tatsuya Sako Rikitaro Fujii Ami Nagasaka Kazuaki Hondera Tetsuichi Ozasa Yoshihumi
- 出版者
- 脳機能とリハビリテーション研究会
- 雑誌
- Journal of Rehabilitation Neurosciences (ISSN:24342629)
- 巻号頁・発行日
- vol.20, no.JPN, pp.42-48, 2020 (Released:2020-10-09)
We report a case of left thalamic hemorrhage with motor paralysis in the right upper and lower extremities, somatosensory dysfunction, right homonymous hemianopsia, decreased spontaneity, and amnestic aphasia five months after onset of hemorrhage. The brain image findings revealed that it was a case of thalamic hemorrhage originating from the thalamic geniculate artery, and the major lesional area was the posterior thalamic region, including the posterolateral ventral nucleus, the median nucleus, part of the dorsal medial nucleus, the lateral ventral nucleus, and the pulvinar. In addition, Parkinson’s-like symptoms were occasionally observed five months after thalamic hemorrhage onset, and these might be associated with a previous right putaminal hemorrhage. Here, we report the clinical course and neuro-imaging findings from the onset of thalamic hemorrhage to five months post-event and discuss the causative factors of each clinical finding.