Alien Hand Sign and Other Cognitive Deficits following Ruptured Aneurysm of the Anterior Communicating Artery

Parkin, Alan J.; Barry, Caroline

doi:10.1155/1991/419342

Cited by 10 publications

(2 citation statements)

References 23 publications

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“…B. performed poorly on the CET (Parkin, Leng, Stanhope & Smith, 1988), whereas case M.P. demonstrated normal CET performance (Parkin & Barry, 1991). The lack of objective verification of the extent of frontal damage in our head injured and anterior communicating artery aneurysm groups may limit our conclusions regarding those groups, but the direct comparison of our frontally lesioned patients versus non-frontally lesioned patients again revealed no significant difference in CET performance.…”

Section: Discussionmentioning

confidence: 62%

Cognitive estimation in neurological disorders

Taylor¹,

O’Carroll²

1995

British J Clinic Psychol

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The Cognitive Estimation Test (CET) was devised by Shallice & Evans (1978) in an attempt to quantify the tendency observed in some patients with frontal lobe lesions to produce bizarre estimates in response to questions to which people do not usually know exact answers (e.g. 'what is the height of a double-decker bus?'), despite performing normally on standard intelligence tests. In the present study, the CET performance of a large number of patients suffering from head injury, brain tumour, ruptured aneurysm (anterior communicating artery and other), multiple sclerosis, dementia, encephalitis, Korsakoff's syndrome and anxiety/depression were compared with CET scores from 150 healthy controls. Patients with Korsakoff syndrome demonstrated significantly impaired CET performance. A subgroup of patients with discrete frontal lesions was compared with a group with localized non-frontal lesions. No significant difference in CET performance was observed between anterior and posterior lesioned patients. The sensitivity of the CET to anterior brain dysfunction is called into question by the present findings.

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Section: Discussionmentioning

confidence: 62%

Cognitive estimation in neurological disorders

Taylor¹,

O’Carroll²

1995

British J Clinic Psychol

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“…Tanaka et al [9] defined this syndrome as a "peculiar dissociative behavior of the left hand in the absence of pathological grasping phenomena: the left hand often acted at cross-purposes to the right". Parkin proposed that normally the hemisphere ipsilateral to the intended hand is inhibited by the contralateral hemisphere via the corpus callosum [7]; in patients with callosal damage, this contralateral control is absent, and the ipsilateral hemisphere becomes engaged in the task, thus generating an intermanual conflict.…”

Section: Dear Editormentioning

confidence: 99%

Diagnostic dyspraxia by disrupted fiber connections of the posterior corpus callosum after distal anterior cerebral artery aneurysm rupture

et al. 2014

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Dear Editor,We would like to report a well-documented case of diagnostic dyspraxia as a consequence of a ruptured distal anterior cerebral artery (DACA) aneurysm. Radiological findings on tractography permit a better understanding of the physiopathology and anatomo-clinical correlations between diagnostic dyspraxia and intracranial hemorrhage secondary to a DACA aneurysm rupture.A right-handed patient presented with brutal onset of left temporal headache. Clinical examination revealed a Glasgow Coma Scale of 14 with a right crural hemiparesis. The cerebral CT scan showed a subarachnoid hemorrhage Fisher grade IV ( Fig. 1a), with the majority of the blood in the pericallosal cistern. The angio-CT demonstrated a right A2 aneurysm at the pericallosal-callosomarginal junction; this was treated immediately by urgent endovascular coiling with no periprocedural complications.On day 1, the patient complained about the feeling of oppositional behavior from his non-dominant hand against his dominant hand. The left hand-dissociative movements were triggered by voluntary activities of his right hand: when we asked the patient to take an object with his right hand, his left hand seized the object before the right hand had time to reach it. The patient never doubted that the left hand was part of his own body, and he had no left/right hand confusion, but he felt that his left hand had its own will. No frontal release signs such as grasping or perseverance were observed. Neuropsychological testing showed language difficulties and clinical signs of callosal disconnection (bilateral taping disturbance, interdigital transfer difficulties, left tactile extinction) associated with executive dysfunction.In the subacute phase, T2-and DWI-weighted MRI images showed involvement of the body and splenium of the corpus callosum with residual blood in the pericallosal cistern (Fig. 1b). The tractographic analysis confirmed the interhemispheric disconnection at the posterior third of the corpus callosum with a complete interruption of the commissural fibers (Fig. 1c, d).The patient underwent a specialized rehabilitation and had a good recovery with a complete return to autonomous daily life activities.DACA aneurysms account for about 3 to 7 % of intracranial aneurysms, most of which commonly arise at the bifurcation of the pericallosal and calloso-marginal arteries [3]. Ruptured DACA aneurysms are smaller than in other sites and are associated with more frequent intracerebral hematomas [4].The Alien Hand Syndrome (AHS) was first described by Goldstein as a variety of clinical conditions whose common characteristic is the uncontrolled behavior or the feeling of strangeness of one extremity, most frequently involving the left hand [1,2].The common classification distinguishes between the posterior, or sensory form, of AHS and the anterior, or motor form, of this condition. To explain inconsistencies such as the phenomenon of diagonistic dyspraxia, Aboitiz (2003) proposed the distinction of five classes of AHS with peculiar clinical manifestati...

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Human Memory Dysfunctions Due to Septal Lesions

Cramon

Markowitsch²

2000

The Behavioral Neuroscience of the Septal Region

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Alien Hand Sign and Other Cognitive Deficits following Ruptured Aneurysm of the Anterior Communicating Artery

Cited by 10 publications

References 23 publications

Cognitive estimation in neurological disorders

Cognitive estimation in neurological disorders

Diagnostic dyspraxia by disrupted fiber connections of the posterior corpus callosum after distal anterior cerebral artery aneurysm rupture

Human Memory Dysfunctions Due to Septal Lesions

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