Gerstmann's syndrome

Mô tả: Gerstmann’s syndrome is a disorder of higher visuospatial function.86 Gerstmann’s syndrome is a tetrad:6 1 acalculia – difficulty with simple addition and subtraction 2 agraphia – difficulty with writing a sentence 3 leftright confusion – difficulty identifying left- and right-sided body parts 4 finger agnosia – difficulty correctly identifying each finger. Typically, other deficits coexist (e.g. aphasia, apraxia, amnesia and intellectual impairment).6

Nguyên nhân: Common • MCA territory cerebral infarction • Cerebral haemorrhage • Vascular dementia Less common • Alzheimer’s disease • Mass lesion (e.g. tumour, abscess, AVM)

Cơ chế: Gertsmann’s syndrome is typically associated with a lesion in the angular gyrus of the dominant parietal lobe.86,89 Each component of Gertsmann’s syndrome, individually, has poor localising value and can occur with a variety of lesions. It is unclear whether the four components of Gerstmann’s syndrome truly share a common neural pathway or whether they cluster together in large, dominant parietal lesions.86,89 A recent study, using structural and functional neuroimaging in normal subjects, mapped cortical activation patterns of the brain associated with components of Gerstmann’s tetrad. Each component of Gerstmann’s syndrome was associated with a variety of cortical and subcortical regions. Gerstmann’s syndrome likely results from damage to a focal region of subcortical white matter resulting in intraparietal disconnection.87

Ý nghĩa lâm sàng: Gerstmann’s syndrome is a dominant cortical localising sign.