Route Learning Impairment Associated with Encephalomalasia Secondary to Traumatic Brain Injury: A Case Report

Abstract

Topographical disorientation is marked by difficulty finding one's way in familiar or new environments. The present case study reports findings from a 30-year-old male with encephalomalasia of the left parahippocampal region secondary to brain trauma with subsequent difficulty in learning of new routes. His navigation in premorbidly known (familiar) surroundings was intact. Magnetic resonance images revealed left parahippocampal and bilateral occipital encephalomalasia. Neuropsychological screening showed impairment in structuring a representation of the spatial relationships among landmarks with relatively preserved ability to learn visual and verbal information of these landmarks. Decreased visual perception and inappropriate visual inputs due to cervical dystonia and right homonymous hemianopsia also appear to play a role in his disability. The current knowledge about the neuronal systems involved in visual cognition and topographical orientation also are addressed in this report.

A Review of Indoor Localization Technologies: towards Navigational Assistance for Topographical Disorientation

“…This diversity makes it difficult to grasp the potential of an existing technology for the rehabilitation of individuals with topographical disorientation. Localization technologies are critical to emerging location-aware guidance systems and support services for individuals who have wayfinding difficulties due for example to low vision [69], stroke [86] and traumatic brain injury [6]. In particular, regarding indoor navigation systems for individuals with topographical disorientation, localization has often been human-mediated rather than automatic.…”

Classification of navigation impairment: A systematic review of neuropsychological case studies

“…In addition to Maguire and colleagues' patient (2006) and the two patients presented by Van der Ham and colleagues (2010), further primary evidence for pathbased navigation impairment is offered by seven case reports (Bottini et al, 1990;Hécaen et al, 1980;Hublet & Demeurisse, 1992;Katayama et al, 1999;Rusconi et al, 2008;Suzuki et al, 1998;Turriziani et al, 2003). Given that only very limited information was available about the navigation assessments of three further patients (Alemdar et al, 2008; patient 1 in Habib & Sirigu, 1987;Osawa et al, 2006), these reports are interpreted as probable evidence for path-based navigation impairment.…”

“…In contrast, they fail when the landmarks are identical. Hence, difficulties with this type of task occur when the patients have to rely solely on spatial information or the structure of paths as depicted on the map (Alemdar et al, 2008;Bottini et al, 1990;Hécaen et al, 1980;Hublet & Demeurisse, 1992;Katayama et al, 1999;Turriziani et al, 2003). An illustration of defective transfer of map representations to the real-world is provided by the patient described by Suzuki and colleagues (1998).…”

Psychosis in a case of encephalomalacia

“…Although very few published data on encephalomalacia are available in the case of human beings, most of the articles are related to infants and children but rarely adults. [3] Almost all of them are related to neurological and/or seizure disorders. [345] In adults with encephalomalacia, rare case reports are available who presented with psychiatric morbidities in the form of progressive mental decline, borderline dementia, features of depression, delusion, and oedipism.…”

“…[3] Almost all of them are related to neurological and/or seizure disorders. [345] In adults with encephalomalacia, rare case reports are available who presented with psychiatric morbidities in the form of progressive mental decline, borderline dementia, features of depression, delusion, and oedipism. [67] Here, we present a case of encephalomalacia in an adult female who presented with psychiatric symptomatology suggestive of psychosis.…”