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J Korean Neurol Assoc. 2003;21(3):239-247.
- "Strategic Infarct Dementia: Clinical Features, Neuroimaging and
Neuropsychological Findings"
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Kyung Won Park
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Department of Neurology, College of Medicine, Dong-A University
- 전략적 뇌경색 치매:임상적 특징,뇌영상 및 신경심리학적 소견
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박경원 , 하병립 차재관 김상호 강도영 김재우
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동아대학교 의과대학 신경과학교실,핵의학교실
- Abstract
- "Background: Strategic infarct dementia (SID) is characterized by focal ischemic lesions involving specific sites that
are critical for higher cortical functions. However, the mechanisms of SID are not well understood. We evaluated lesion
sites, neuropsychiatric symptoms, neuroimaging and neuropsychological findings in patients with SID and have come
up with suggestions of the mechanism behind SID. M e t h o d s: Eleven patients with SID according to the NINDS-AIREN
criteria for vascular dementia were included. All patients were given a neurologic examination, brain MRI with
MRA and brain perfusion SPECT using Tc-99m HMPAO. We evaluated neuropsychiatric symptoms and neuropsycho-logical
status using a Korean-version of the Neuropsychiatric Inventory(K-NPI) and Seoul Neuropsychological
Screening Battery. Results: Various sites were responsible for SID; the thalamus (n=5), genu of internal capsule (n=2),
temporooccipital lobe (n=2), medial temporal lobe (n=1), medial frontal lobe (n=1). The most common neuropsychi-atric
symptom was apathy according to the K-NPI. Brain perfusion SPECT revealed ipsilateral cortical hypoperfusion,
mainly in the frontal and temporal areas. In several cases, there were some degrees of cortical hypoperfusion in the con-tralateral
areas of the lesion. On neuropsychological assessment, cognitive deficits on attention and frontal executive
function were prominent. C o n c l u s I o n s: The thalamus, genu of internal capsule, and temporooccipital area were the
most common sites responsible for SID. Based on the results that there were cortical hypoperfusion ipsilateral to sub-cortical
strategic infarct and prominent cognitive deficits on attention and frontal executive function, it is suggested that
disruption of the frontal-subcortical circuit may play an important role in patients with SID.Key Words: Vascular dementia, Cerebral infarction, MRI, SPECT, Neuropsychological test"
Keywords :
- 초록
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