Gerstmann Syndrome (GS) is a rare neurological condition described as a group of cognitive changes corresponding to a tetrad of symptoms comprising agraphia, acalculia, right-left disorientation and finger agnosia. It is known that some specific brain lesions may lead to such findings, particularly when there is impairment of the angular gyrus and adjacent structures. In addition, the possibility of disconnection syndrome should be considered in some cases. The purpose of this article is to report a case of a young, cardiac patient, non-adherent to treatment, who presented with a stroke in which transient clinical symptoms were compatible with the tetrad of GS. The case report is followed by a discussion and brief review of the relevant literature.

Disconnection syndromes are classified as higher function deficits that result from lesions to white matter or association cortices, the latter acting as relay stations between primary motor, sensory, and limbic areas. In 1965, Norman Geschwind brought disconnection to the fore after publishing a paper entitled "Disconnexion syndromes in animals and man." In the last decades, a large number of studies concerning this topic have been published in order to elucidate new perspectives of localizationist view of brain functioning. In view of those considerations, it is noteworthy to mention that the understanding of connection pathways involving frontal lobe is one of the most challenging fields of research in neuroscience. The better comprehension of those concepts is an important mark for the multidisciplinarity of neurology, neurosurgery, and psychiatry. The purpose of this chapter is to expose relevant data of recent literature embracing the association between disconnection syndromes and frontal lobe dysfunction.