TY - JOUR
T1 - A case of micrographia after subcortical infarction
T2 - Possible involvement of frontal lobe function
AU - Nakamura, M.
AU - Hamamoto, M.
AU - Uchida, S.
AU - Nagayama, H.
AU - Amemiya, S.
AU - Okubo, S.
AU - Tanaka, K.
PY - 2003/9
Y1 - 2003/9
N2 - Most reports of micrographia associated with focal brain lesions have related this finding to damage in the left basal ganglia. Here we describe the case of a 68-year-old man presenting with reversible micrographia accompanied by hypophonia in the absence of extrapyramidal signs after cerebral infarction in the left subcortical region. At the time of the patient's admission, diffusion-weighted magnetic resonance imaging sequence showed the lesion to principally involve the corona radiata, with some involvement of the putamen. Neurologically, mild right-sided brachiofacial hemiparesis and grasp reflexes - a frontal lobe sign - were observed. As his micrographia and hypophonia improved, the patient's grasp reflexes improved in parallel. In addition, recovery of regional cerebral blood flow in the left frontal lobe was confirmed by single photon emission computed tomography (technetium-99 m HMPAO). The present case suggests the possibility that the function of frontal-subcortical circuit might also be involved in the production and improvement of micrographia and that micrographia and hypophonia may share a common pathophysiology.
AB - Most reports of micrographia associated with focal brain lesions have related this finding to damage in the left basal ganglia. Here we describe the case of a 68-year-old man presenting with reversible micrographia accompanied by hypophonia in the absence of extrapyramidal signs after cerebral infarction in the left subcortical region. At the time of the patient's admission, diffusion-weighted magnetic resonance imaging sequence showed the lesion to principally involve the corona radiata, with some involvement of the putamen. Neurologically, mild right-sided brachiofacial hemiparesis and grasp reflexes - a frontal lobe sign - were observed. As his micrographia and hypophonia improved, the patient's grasp reflexes improved in parallel. In addition, recovery of regional cerebral blood flow in the left frontal lobe was confirmed by single photon emission computed tomography (technetium-99 m HMPAO). The present case suggests the possibility that the function of frontal-subcortical circuit might also be involved in the production and improvement of micrographia and that micrographia and hypophonia may share a common pathophysiology.
KW - Cerebral infarction
KW - Frontal-subcortical circuit
KW - Grasp reflex
KW - Hypophonia
KW - Micrographia
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U2 - 10.1046/j.1468-1331.2003.00641.x
DO - 10.1046/j.1468-1331.2003.00641.x
M3 - Article
C2 - 12940845
AN - SCOPUS:0142119361
SN - 1351-5101
VL - 10
SP - 593
EP - 596
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 5
ER -