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Case 11 - The Stroke of Clarity

from Part 3 - Missing Important Clues in the History

Published online by Cambridge University Press:  03 November 2020

Keith Josephs
Affiliation:
Mayo Clinic Alzheimer’s Disease Research Center
Federico Rodriguez-Porcel
Affiliation:
Medical University of South Carolina
Rhonna Shatz
Affiliation:
University of Cincinnati
Daniel Weintraub
Affiliation:
University of Pennsylvania
Alberto Espay
Affiliation:
University of Cincinnati
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Summary

This 75-year-old right-handed woman presented with a nine-month history of progressive cognitive impairment. Her children reported that the first problem was, abruptly, an inability for her to see things on the left side of her visual field. In the hospital, she was found to have left homonymous hemianopia associated with a stroke in the right occipital lobe. During her admission she appeared disoriented, claiming she was at her mother’s house. Repeat imaging was unchanged, and metabolic and infectious workups did not show abnormalities. She returned to baseline before the discharge. After her discharge, her children noted progressive decline. She became increasingly forgetful about recent events and repetitive in her questions and statements. Due to the temporal correlation between these symptoms and the stroke, she was diagnosed with poststroke dementia.

Type
Chapter
Information
Common Pitfalls in Cognitive and Behavioral Neurology
A Case-Based Approach
, pp. 35 - 37
Publisher: Cambridge University Press
Print publication year: 2020

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References

Ferro, J. M. 2001. Hyperacute cognitive stroke syndromes. J Neurol 248(10) 841849.CrossRefGoogle ScholarPubMed
Godefroy, O. and Bogousslavsky, J. 2007. The Behavioral and Cognitive Neurology of Stroke. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
Jorm, A. F. 1994. A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): development and cross-validation. Psychol Med 24(1) 145153.CrossRefGoogle Scholar
Mori, E. 2002. Impact of subcortical ischemic lesions on behavior and cognition. Ann N Y Acad Sci 977 141148.CrossRefGoogle ScholarPubMed
Schmahmann, J. D. 2003. Vascular syndromes of the thalamus. Stroke 34(9) 22642278.CrossRefGoogle ScholarPubMed
Smith, E. 2016. Vascular cognitive impairment. Continuum 22(2) 490509.Google ScholarPubMed

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