We report a case of a 67-year-old man with left thalamic hemorrhage. He had right hemiplegia, aphasia, and higher brain dysfunction. The hemiplegia and aphasia improved with rehabilitation treatment；however, he was unable to perform activities of daily living. Visual and tactile agnosia was suspected using the visual perception test for agnosia 1 month after the hemorrhage. The patient was able to recognize common objects, such as chopsticks and a shaver, by labeling them with their names because he could read words. He was able to use these objects as a result. Multimodal agnosia with combined visual-tactile agnosia usually occurs as lesions in and around the left lateral occipital complex where the ventral stream of somatosensory information processing merges with that of visual information processing. Concurrently, the present case seems very unusual because multimodal agnosia was likely to have occurred as a lesion of the left thalamus. The compensatory strategy to put objects into words was effective in this case. We repeatedly assessed and analyzed his higher brain dysfunction in detail, which led to effective rehabilitation treatment. The present case highlights the importance of planning an appropriate treatment based on detailed evaluation and accurate diagnosis of the higher brain dysfunction in patients with neurological deficits.

We report a case of a 67-year-old man with left thalamic hemorrhage. He had right hemiplegia, aphasia, and higher brain dysfunction. The hemiplegia and aphasia improved with rehabilitation treatment；however, he was unable to perform activities of daily living. Visual and tactile agnosia was suspected using the visual perception test for agnosia 1 month after the hemorrhage. The patient was able to recognize common objects, such as chopsticks and a shaver, by labeling them with their names because he could read words. He was able to use these objects as a result. Multimodal agnosia with combined visual-tactile agnosia usually occurs as lesions in and around the left lateral occipital complex where the ventral stream of somatosensory information processing merges with that of visual information processing. Concurrently, the present case seems very unusual because multimodal agnosia was likely to have occurred as a lesion of the left thalamus. The compensatory strategy to put objects into words was effective in this case. We repeatedly assessed and analyzed his higher brain dysfunction in detail, which led to effective rehabilitation treatment. The present case highlights the importance of planning an appropriate treatment based on detailed evaluation and accurate diagnosis of the higher brain dysfunction in patients with neurological deficits.

Immunization Health Damage Relief Program is a system created with the aim of providing “quick and wide-ranging” relief for health damage caused by routine vaccinations. In this study, we investigated the current status of payments awarded for side effects of the human papilloma virus (HPV) vaccine over the 10-year period from 2013 to 2023. We obtained the data for this study from reports of the subcommittees of the Vaccination Health Damage Relief System, such as the results of deliberations by the Infectious Diseases and Immunization Review Subcommittee. The certification rate under this system was approximately 50%, which is the same as the certification rate of the Adverse Drug Reaction Relief System. The types of diseases and disorders reported in the system were diverse and had multiple symptoms. The number of applications increased in the final year of the study because of the recommendation for reopening the system for applications in 2022.

Objective: The Immunization Health Damage Relief Program was established to provide "prompt and wide-ranging" relief for health damage caused by routine vaccination.Methods: In this study, utilizing the report of the Subcommittee on Infectious Diseases and Immunization, we investigated the relief status of persons who received the new coronavirus vaccine. The study period was three years, from 2021 to 2023, and the number of cases accepted, the number of certifications, the number of denials, and the number of delays were analyzed.Results: Most of the claims were for medical expenses and medical benefits, and the remaining claims were for lump-sum death benefits and funeral expenses. The approval rate was 84.9%, and the denial rate was 14.1%. The scrutiny rate was less than 30% since July 2022, but with the establishment of a new study group on January 2023, the rate rose to approximately 70%. Initially, none of the lump-sum death payments were approved, but later the approval rate increased, and there was a period when almost all the lump-sum death payments were approved.Conclusions: The Ministry of Health, Labor and Welfare (MHLW) is responding as quickly as possible to the increasing number of applications, but the number of health relief applications is unprecedented in the history of vaccines. For the victims and their families, the situation does not appear to be satisfactory.