Abstract
Behavioral disorders were a prominent clinical feature after the surgical treatment of an anterior communicating artery aneurysm rupture in a 44-year-old man. Callosal apraxia was associated with an alien hand. The latter remained 1 year after surgery while diagonistic apraxia disappeared after 3 months. Other callosal signs included left agraphia, tactile anomia and auditory suppression. MRI revealed posterior callosal infarction and a right frontal infarct. The association of diagonistic apraxia and alien hand is rarely reported.
Highlights
The first description of a disconnection syndrome is attributed to Liepmann (1907) who reported the occurrence of apraxia, unilateral agraphia and hemialexia in a patient with anterior cerebral artery infarction
Diagonistic apraxia, in which the non-dominant hand is in conflict with volitional action of the dominant hand, is associated with autocriticism and frustration due to the intennanual conflict (Starkstein et al, 1988)
Our patient showed both intennanual conflict and grasping uncooperative movements suggesting the association of alien hand and diagonistic apraxia
Summary
Behavioral disorders in association with posterior callosal and frontal cerebral infarction. Departments Of1 Neurosurgery and 2Neurology, CHRU Lille, 59037 Lille Cedex, France Correspondence to: D. Behavioral disorders were a prominent clinical feature after the surgical treatment of an anterior communicating artery aneurysm rupture in a 44-year-old man. Callosal apraxia was associated with an alien hand. The latter remained 1 year after surgery while diagonistic apraxia disappeared after 3 months. Other callosal signs included left agraphia, tactile anomia and auditory suppression. MRI revealed posterior callosal infarction and a right frontal infarct. The association of diagonistic apraxia and alien hand is rarely reported
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