Abstract
ABSTRACTBackground: The claustrum is a brain structure found in both hemispheres beneath the inner surface of the neocortex in the region of the insula and is bordered by the external and extreme capsule. Generally, it is divided into a dorsal part (claustrum proper or insular claustrum) and ventral part (endopiriform nucleus). The claustrum possesses complex reciprocal connections with the cortex, striatum, dorsal thalamic nuclei and hippocampus. Reports of patients with unilateral lesion of the claustrum are few in number. Herein, we present a case report of an ischemic stroke restricted to the left claustrum in a 55-year-old femaleCase Report: The patient presented with intense feeling of dizziness, ataxic gait, sensation of ‘vacuity’ in the head, decreased hearing and abnormal gustatory sensations. The neurological examination revealed a mixed horizontal and rotary nystagmus to the right side. Brain CT upon admission was assessed as normal without pathological findings. MRI was performed and showed an ischemic stroke restricted to the left claustrum with no other lesions. Following 4 weeks of therapy the patient recovered fully and duplex sonography showed preserved circulation in the affected areas.Conclusion: The present case report underlines the complexity of clinical symptomatology of the claustrum.
Highlights
The claustrum is a brain structure found in the telencephalon of most mammalian species [1–3]
The claustrum is divided into a dorsal part and ventral part [1–3,7]
We present a case report of an ischemic stroke restricted to the left claustrum in a 55-year-old female and comment on the clinical implications of such injury
Summary
The claustrum is a brain structure found in the telencephalon of most mammalian species [1–3] It is a thin, vertical, sheet-like structure with irregular shape, found in both hemispheres beneath the inner surface of the neocortex in the region of the insula [4]. Several hours later other symptoms developed such as sensation of ‘vacuity’ in the head, abnormal feeling of discomfort in the epigastric region (without nausea or vomiting), decreased hearing in the left ear, abnormal gustatory sensation (paresthesia) in the left half of the tongue and paresthesia in the left peribuccal region spreading to the left half of the face and affecting the whole left half of the head Her blood pressure was measured as 110/60 mmHg. Duplex sonography of the carotid and vertebral arteries was performed and revealed mild atherosclerosis of both carotid bifurcations. Follow-up MRI revealed a local ischemic stroke restricted only to the left claustrum (Fig. 2)
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