Capsular Genu Infarction Presenting with Confusional Syndrome: An Analysis of Clinical and Neuroradiologic Findings.
- Author:
Jeong Ho HA
1
;
Jong Sung KIM
;
Jae Hong LEE
;
Myoung Chong LEE
Author Information
1. Department of Neurology, Ulsan University College of Medicine, Asan Medical Center.
- Publication Type:Original Article
- MeSH:
Apathy;
Brain;
Cerebral Cortex;
Cerebrum;
Dementia;
Diagnosis, Differential;
Disorders of Excessive Somnolence;
Frontal Lobe;
Humans;
Infarction*;
Internal Capsule;
Magnetic Resonance Imaging;
Memory;
Neurons;
Perfusion;
Tomography, Emission-Computed, Single-Photon;
Tomography, X-Ray Computed
- From:Journal of the Korean Neurological Association
1996;14(2):371-381
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We reviewed 5 patients with infarcts involving the genu of the internal capsule, who revealed behavioral changes and cognitive defects. They developed an acute confusion and/or dementic feature along with other behavioral changes characterized by apathy, hypersomnia, memory impairment, and cognitive impairment, mimicking frontal lobe dysfunction. Brain MRI and/or CT scan localized the lesion to the genu of the internal capsule. Brain perfusion SPECT performed in 3 patients showed hypoperfusion in ipsilateral cerebral hemisphere. Two mechanisms are suggested to explain the development of confusion or dementia after capsular genu infarct. (I) a disconnection or diaschisis of thalamo-cortical interconnection (ii) selective neuronal loss of cerebral cortex due to chronic MCA or ICA occlusion with insufficient collateral blood flow. We suggest that capsular-genu infarction as a cause of acute confusion or dementia must be included in differential diagnosis.
