Abstract
Strategic regions correspond to associative, limbic and paralimbic structures and
related circuits, that underpin cognitive/behavioral functions. Strokes in these eloquent
sites produce pictures of vascular dementia with syndromic features due to specific
site lesion and/or interruption of their interconnections. This study aims at analysing
subcortical strategic strokes that express similar cognitive/behavioral elements,
by sharing common pathways. Patients (n=6) who attended in specialized ambulatory, were submitted to neuropsychological and
neuroimaging assessments through MRI (GE Signa Horizon 1.5T) and brain SPECT (Millennium
MG, ECD [TC-99m]). Stroke locations and respective main symptoms were: 1. anteromedian
thalamus [L]: anterograde and retrograde amnesia (ARA), expression aphasia (EA), executive
dysfunction (ED), apathy, and depression; 2. anterior thalamus [R]: ARA, inattention,
apathy, and aggressiveness; 3. dorsomedian thalamus [L]: inattention, ED, anosognosia,
and aggressiveness; 4. central paramedian thalamus [R]: EA, visual perception deficits
(VPD), ED, infantility, and personality disorder; 5. caudate nucleus (ventral-head)
[L]: VPD, ED, delirium, visual hallucinations, and personality disorder; and 6. anterior
capsule [L]: VPD, ED, apathy, and depression. Vascular strategic syndromes connote
the predominantly impaired cognitive/behavioral symptom of each site. Temporal and
frontal disconnection symptoms were produced by disrupted MTT/hippocampal and IML/amygdala
circuits expressing amnesic syndrome associated with heterogeneous dysexecutive syndrome,
in all the cases, by disrupting frontal–basal ganglia–thalamus–cortical net, in three
different levels of their pathway.
Keywords
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Article info
Publication history
Published online: August 30, 2012
Accepted:
August 7,
2012
Received in revised form:
August 4,
2012
Received:
January 31,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
