Skip to main content Accessibility help
  • Print publication year: 2011
  • Online publication date: May 2011

Case 12 - Progressive difficulty with naming and object identification


This chapter describes right-sided numbness using the case of an 82-year-old woman who had a former history of hypertension, type 2 diabetes treated with oral hypoglycemic agents, rheumatoid arthritis, dysthymic disorder, and left dorsal herpes zoster with residual postherpetic neuralgia. The physical examination showed a conscious patient with moderate motor aphasia, right homonymous hemianopsia, and balanced faciobrachiocrural hemiparesis in association with hemihypoesthesia of the right hemibody. The brain magnetic resonance imaging (MRI) scan showed acute cerebral ischemia in the territory of the left middle cerebral artery. A diagnosis of cerebral infarction of cardioembolic origin was made. A final tentative diagnosis of vascular cognitive impairment that fulfilled criteria of multi-infarct dementia was established. Living performance after stroke was severely impaired and home assistance for daily living activities was needed. Treatment for the cognitive impairment includes speech therapy and physical rehabilitation.

References and further reading

HodgesJR, MitchellJ, DawsonK, et al. (2009). Semantic dementia: demography, familial factors and survival in a consecutive series of 100 cases. Brain, 132, 2734–46.
HodgesJR, PattersonK (2007). Semantic dementia: a unique clinicopathological syndrome. Lancet Neurol, 6, 1004–14.
JohnsonJK, DiehlJ, MendezMF, et al. (2005). Frontotemporal lobar degeneration: demographic characteristics of 353 patients. Arch Neurol, 62, 925–30.
JokelR, RochonE, LeonardC (2006). Treating anomia in semantic dementia: improvement, maintenance, or both?Neuropsychol Rehabil, 16, 241–56.
MesulamMM (2007). Primary progressive aphasia: a 25-year retrospective. Alzheimer Dis Assoc Disord, 21, S8–S11.
NearyD, SnowdenJS, GustafsonL, et al. (1998). Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology, 51, 1546–54.
RohrerJD, GuerreiroR, VandrovcovaJ, et al. (2009). The heritability and genetics of frontotemporal lobar degeneration. Neurology, 73, 1451–6.
SnowdenJ, GouldingPJ, NearyD (1989). Semantic Dementia: a form of circumscribed cerebral atrophy. Behav Neurol, 2, 167–82.
SnowdenJ, NearyD, MannD (2007). Frontotemporal lobar degeneration: clinical and pathological relationships. Acta Neuropathol, 114, 31–8.
ThompsonSA, PattersonK, HodgesJR (2003). Left/right asymmetry of atrophy in semantic dementia: behavioral-cognitive implications. Neurology, 61, 1196–203.