Caudal Cingulate Infarction Manifesting Astasia

Abstract

Introduction: Astasia is a rare presenting symptom of stroke, usually known as ‘thalamic astasia', induced by a lesion in the ventrolateral thalamus. We report a case of caudal cingulate infarction manifesting astasia. Case Presentation: A 58-year-old male presented with inability to sit, stand and walk (astasia). No apparent motor weakness was noticed in the extremities. MRI revealed cerebral infarction in the caudal cingulate gyrus, which was located between the vertical commissure anterior (VCA) line and vertical commissure posterior (VPC) line. His symptoms persisted for 1 year to a lesser degree. Conclusion: Lesions in the caudal cingulate gyrus can present with astasia. The responsible lesion is located in the cingulate gyrus between the VCA and VPC line, which might correspond to the caudal cingulate zone in humans. We should keep in mind that astasia can be a presenting symptom of stroke.

Isolated astasia caused by a localized infarction in the suprathalamic white matter

“…Repetitive scrubbed movements of the fingers was observed as initial manifestation. Satow et al . described a second reported case of astasia caused by a posterior cingulate gyrus infarction.…”

“…In addition to astasia, dysarthria, and ataxia in the unilateral upper extremity were observed. The authors speculated that the disruption of connection between the cingulate motor area and the vestibulocerebellar system through the thalamus might induce astasia. Zhang et al .…”

“…Astasia designates motor incoordination with inability to stand, despite good strength . Because astasia is a rare symptom, its pathogenesis remains uncertain.…”

“…Because astasia is a rare symptom, its pathogenesis remains uncertain. Regarding responsible region for astasia, the thalamus, thalamo‐mesencephalic junction, mesencephalon, pontomesencephalic locomotor region, posterior cingulate gyrus, and supplementary motor area were reported (Table ). We herein describe a first reported case of isolated astasia due to a suprathalamic white matter infarction.…”

Transient Global Amnesia Associated with an Acute Infarction at the Cingulate Gyrus

“…In this case report, we show that a cingulate infarction can cause transient global amnesia (TGA). Cingulate gyrus infarct is unusual and could cause other syndromes like astasia (inability to sit, stand, and walk) and dysarthria, probably as a result of the relationship with vestibular and cerebellar nucleus [ 3 ].…”