A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke
Gerstmann Syndrome is a rare neurological presentation due to a lesion in the left dominant parietal lobe, manifesting as a tetrad of agraphia, acalculia, finger agnosia and right-left disorientation. We present a case of a 52-year-old man, right handdominant, who presented to the Emergency Depart...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Pusat Perubatan Universiti Kebangsaan Malaysia
2022
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| Online Access: | http://journalarticle.ukm.my/19678/1/22_ms0430_pdf_20213.pdf http://journalarticle.ukm.my/19678/ https://www.medicineandhealthukm.com/toc/17/1 |
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| Summary: | Gerstmann Syndrome is a rare neurological presentation due to a lesion in the left
dominant parietal lobe, manifesting as a tetrad of agraphia, acalculia, finger agnosia
and right-left disorientation. We present a case of a 52-year-old man, right handdominant, who presented to the Emergency Department with acute confusion for
one day. He was disorientated to time, place and person. Focused neurological
examination revealed atypical signs of acute stroke, comprising agraphia,
acalculia, finger agnosia and right-left disorientation. Stroke protocol was activated
and he underwent computed tomography brain perfusion, which confirmed
a large penumbra area at the left middle cerebral artery territory. Computed
tomography angiogram of the carotid arteries showed a long segment thrombosis
in the left internal carotid artery. Emergency thrombectomy was abandoned due
to impenetrable hard thrombus. He was treated with dual antiplatelet therapy
and discharged after three days with partial improvement in terms of following
commands, simple calculations and reduced finger agnosia. He was scheduled
for outpatient follow up. This case highlights Gerstmann syndrome as an atypical
manifestation of acute stroke. |
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