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S Maeshima

Publications and source records attributed to S Maeshima.

At least 37 records · Page 2Linked to original sources
PubMed1998

Gerstmann's syndrome associated with chronic subdural haematoma: a case report.

We report a patient who exhibited Gerstmann's syndrome in association with a chronic subdural haematoma. A 71-year-old right-handed woman presented with mild right arm and leg weakness that began 2 weeks prior to admission. Neurological examination on admission revealed a mild right hemiparesis. Neuropsychological examination revealed right-left disorientation, finger agnosia, agraphia, and acalculia, but no language disturbance. A computerized tomographic (CT) scan revealed a large left frontoparietal, extra-axial hypodense fluid collection containing scattered hypodense foci. A left parietal evacuation of the haematoma was performed. Following surgery the patient dramatically improved. We suggest that the direct compression by the chronic subdural haematoma or a hemispheric pressure difference caused Gerstmann's syndrome. This is an unusual report of a Gerstmann's syndrome following chronic subdural haematoma.

Aged↗
PubMed1998

[A case of agraphia due to cerebral infarction in the left parietal lobe].

A case of agraphia due to cerebral infarction in the left parietal lobe was reported. A 63-year-old right-handed man was admitted to our hospital with writing disturbance. His spontaneous speech was fluent, and object naming, word fluency, repetition, verbal comprehension, and reading were fully preserved. However, his writing was slow and required effort. He showed hesitation in spontaneous writing and dictation. His power to copy was better than his power to write spontaneously or to take dictation, but he had some difficulty in copying letters and complex figures. The patient showed abnormal sequences of strokes and completed his strokes by piecing out of several fragments. CT scan and MRI showed a cerebral infarction in the left parietal lobe which included the superior parietal lobule. The amytal (Wada) test, which was performed via the left internal carotid artery, revealed that the left hemisphere was dominant for language. The characteristics of his agraphia much more closely resembled "apractic agraphia", as reported by Alexander et al (1992), than spatial agraphia or pure agraphia. Agraphia in this patient might result partially from the loss or unavailability of the memory of motor patterns necessary for writing letters.

Agraphia↗
PubMed1997

Is unilateral spatial neglect a single phenomenon? A comparative study between exploratory-motor and visual-counting tests.

The aim of this study is to report the preliminary findings of a traditional battery of tests and our original battery capable of assessing the presence of components and extent of lesions in patients with unilateral spatial neglect. Thirty patients who had unilateral spatial neglect with a stroke in the right hemisphere were assessed for unilateral spatial neglect on exploratory-motor (E-M) tasks, visual-counting (V-C) tasks, and traditional neglect batteries at least 4 weeks after the onset. Other neuropsychological tests and computed tomography were also performed to investigate the relationship with neglect. A factor analysis showed that our tasks loaded significantly on three factors. E-M neglect was found in 16 patients, and V-C neglect in 22 patients with unilateral spatial neglect. There were high correlations between E-M neglect and motor paralysis, word fluency, backward digit span and motor impersistence. There were high correlations between V-C neglect and visual-field defect, line bisection, line cancellation and figure copying. Lesions in the frontal lobe, caudate, insula, and anterior portion of the paraventricular white matter were commonly associated with E-M neglect. Lesions in the occipital lobe were also associated with V-C neglect. We suggest that unilateral neglect is not a single phenomenon, but rather involves several different components. We propose that E-M and V-C tasks are useful methods for evaluating the extent of lesions in patients with unilateral spatial neglect.

Adult↗
PubMed1997

Cerebral angioplasty in a patient with vascular dementia.

A 66-year-old man with a history of previous transient ischemic attacks had progressive memory and gait disturbance caused by severe stenoses of both the internal carotid arteries and vertebral arteries. The patient underwent percutaneous transluminal angioplasty of the vertebral arteries and endarterectomy of the internal carotid arteries with satisfactory results. On admission, the patient was alert, but disoriented to time and place. He exhibited mild motor weakness in both legs. Neuropsychological tests revealed remarkable intellectual deterioration and he required maximum support to perform activities of daily living. Higher cortical function and the ability to perform activities of daily living improved remarkably after the angioplasty. Angioplasty is an alternative therapy to reverse functional deficits in patients with cerebrovascular hemodynamic compromise.

Aged↗
PubMed1997

Buccofacial apraxia and left cerebral haemorrhage.

We examined 33 patients with left intracerebral haemorrhage to investigate the relations to buccofacial apraxia (BFA). BFA was present in 18 cases at 1 month and disappeared in 3 cases and persisted in 15 cases at 6 month from the onset. The existence of BFA seems to be partially dependent the haematoma volume which may cause the organic damage in lenticulate nucleus, insula, posterior limb or internal capsule and anterior portion of paraventricle white matter. All patients with BFA had aphasia (Broca 6, Wernicke 1, Total 10, Amnestic 1). Aphasia of the patients with transient BFA improved as well as the patients without BFA after BFA disappeared. We suspected that improvement or aphasia might be affected by BFA.

Aphasia↗
PubMed1997

Rehabilitation of patients with anosognosia for hemiplegia due to intracerebral haemorrhage.

We have studied the differences in the lesions, concomitant symptoms and ADL levels in patients in acute-stage cerebral-haemorrhage and manifesting anosognosia. Twelve of 50 patients (24.0%) presented with anosognosia. The (+) group had longer intervals between onset and the first evaluation than did the (-) group, demonstrating severe sensory disturbance. The volume of haemorrhage was significantly larger in the (+) group. Anosognosia disappeared within 3 months in all cases. In the (+) group the time until discharge was long, with the ADL level at the time of discharge being low. Therefore, it was considered that anosognosia was important as an inhibitory factor hampering rehabilitation.

Activities of Daily Living↗
PubMed1997

Impairment of short-term memory in left hemispheric traumatic brain injuries.

We report on two patients with traumatic lesions in the temporal and parietal lobes who demonstrated disturbances of short-term memory (STM) following improvement on the aphasia. Patient 1 was a 66-year-old right-handed man who presented to our hospital with a cerebral contusion. One admission we observed a Wernicke's aphasia with paraphasic jargon in this patient that resolved within 8 weeks. Patient 2 was a 35-year-old right-handed woman, with an acute subdural haematoma and a cerebral contusion, who underwent craniotomy and evacuation of the haematoma. In this patient we noted a transient Wernicke's aphasia following the operation that improved within 3 months. Linguistically, the aphasia observed in each of these two patients was not a typical conduction aphasia because of the absence of paraphasia, and impairment of comprehension was unclear despite a decrease in performance on repetition tasks. Both verbal and non-verbal tasks suggested an impairment in STM. These findings suggest that involvement of the left hemisphere may cause disturbances in both verbal and non-verbal STM.

Adult↗
PubMed1997

Exploratory-motor task to evaluate right frontal lobe damage.

An exploratory-motor (E-M) task was performed by 20 patients with right hemispheric damage and unilateral spatial neglect and by 15 adult controls. None of the subjects in the control group demonstrated E-M neglect, other types of unilateral spatial neglect, or motor impersistence. In the unilateral spatial neglect group, 14 of 20 patients revealed E-M neglect. The presence or absence of E-M neglect related to word fluency, digit span recall (backward), and motor impersistence. In addition, E-M neglect frequency was observed in patients with lesions in the frontal lobe. The frontal lobe may play an important role in the performance of an E-M task. Therefore, we think that E-M task performance is a useful method for evaluating the site of right frontal lobe damage.

Adult↗
PubMed1997

Functional outcome following thalamic haemorrhage: relationship between motor and cognitive functions and ADL.

Twenty-two patients with thalamic haemorrhage were examined to investigate the relationship between motor and cognitive function, and activities of daily living (ADL). Patients with unilateral spatial neglect had lower ADL scores on admission than patients without unilateral spatial neglect (Mean: 17.0 and 24.6, respectively; F = 4.38, df = 1, p < 0.05). Unilateral spatial neglect related to feeding, bowel control and transfer in Barthel index on admission. Patients with aphasia on admission had lower ADL at discharge than patients without aphasia on admission (Mean: 57.0 and 84.7, respectively; F = 7.70, df = 1, p < 0.05). Aphasia related to the bathing, toilet, stair climbing, dressing, and ambulation in Barthel index on discharge. There was a significant difference between the severity of paresis in upper and lower limb on admission and ADL at discharge. The two-way repeated measures ANOVA showed a significant difference between severity of paresis in lower limb and ADL improvement. It can be suggested that the most important predictor of outcome was paresis in lower limb, and not aphasia or unilateral spatial neglect.

Activities of Daily Living↗
PubMed1996

Transcortical mixed aphasia with left frontoparietal lesions.

We present a case of transcortical mixed aphasia following a left frontoparietal infarct caused by vasospasm after subarachnoid haemorrhage. Although CT showed low-density areas in the left frontal lobe and basal ganglia, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere, except for the left perisylvian speech areas. Hence, transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas due to disconnection from surrounding areas.

Aphasia↗
PubMed1996

[A case of amnesic syndrome caused by hematoma in the left anterior medial thalamus].

We reported a case of amnestic syndrome caused by a hematoma in the left thalamus. The case was that of a 68-year-old, right-handed man who suddenly showed amnestic syndrome. He had neither motor paresis nor sensory disturbance. Clinical examination showed he had disorientation, anterograde amnesia and mild retrograde amnesia. Immediate recall and remote memory were intact, but recent memory was severely impaired. CT scan revealed a high density area in the anterior medial part of the left thalamus. We concluded that amnesia in this patient was caused by fasciculus mamillothalamicus damage because of a hematoma during thalamic hemorrhage.

Aged↗
PubMed1996

[Relationship between higher cortical dysfunction and the findings of magnetic resonance imaging in systemic lupus erythematosus].

The relationship between systemic lupus erythematosus (SLE) and organic lesions was investigated by magnetic resonance imaging (MRI) to clarify the etiology of higher cortical dysfunction in SLE. The subjects were 10 patients with SLE, and higher cortical dysfunction was observed in 8 (80%) of the 10 patients. 5 (82.5%) of the 8 patients showed abnormal MRI findings. The findings of higher cortical dysfunction were consistent with the MRI findings in 1 of the 5 patients, but not in the remaining four. MRI revealed no lesion despite the presence of higher cortical dysfunction in three patients. These results suggest that the association of organic changes and functional changes in cerebral nerve cells is important in etiology of higher cortical dysfunction in SLE.

Adult↗
PubMed1996

[Super selective amytal test for functional evaluation of the brain--a less invasive functional test].

In the neurosurgical field, it is very important to evaluate localized function of the affected region preoperatively. In order to investigate lateralized and localized brain function, we have developed an alternative to the original Wada test, and refer to it as the super selective amytal test (SSAT). We performed super selective catheterization of the target artery after conventional carotid angiography, injected Amytal (amobarbital, 30-100 mg) through a micro-catheter, and identified potential local function. In ten cases, including AVM, aneurysm, and brain tumor, we investigated localized function of the affected site preoperatively by SSAT, and chose our treatment based on the results of this test. There was a good correlation between the results of the SSAT and the results of surgery in every case. There were no prolonged neurological complications of this test. Evaluation of the results of the SSAT should be interpreted under precise DSA control, since blood flow in the brain differ among individuals. This test may contribute to our knowledge of localized function in the cerebral cortex and deep brain areas in neurosurgical patients.

Adult↗
PubMed1995

Unilateral spatial neglect due to a haemorrhagic contusion in the right frontal lobe.

We report two cases of unilateral spatial neglect associated with an isolated right frontal lobe lesion. Case 1 was a 59-year-old, right-handed man, who developed a left hemiplegia, disorientation, and frontal lobe neglect associated with a haemorrhagic contusion following a head injury. Case 2 was a 55-year-old, right-handed man, who also developed disorientation and frontal lobe neglect secondary to a haemorrhagic contusion following a head injury. 99mTc HM-PAO SPECT revealed an isolated reduction in the regional cerebral blood flow (CBF) around the haematoma in the frontal lobe; blood flow to remaining parts of the brain was normal. Damage to the right frontal lobes of these patients was confirmed as being the cause of the unilateral spatial neglect in accordance with the results of CBF studies.

Attention↗
PubMed1995

[The effect on higher cortical dysfunction of percutaneous transluminal angioplasty for internal carotid artery stenosis].

Seven patients with internal carotid artery (ICA) stenosis with higher cortical dysfunction due to hemodynamic ischemia were treated by percutaneous transluminal angioplasty (PTA). The patients ranged from 49 to 71 years of age, and included five males and two females. Neuropsychological tests were evaluated before and after PTA. Higher cortical dysfunction improved in all cases after PTA. It is concluded that PTA is effective to improve higher cortical dysfunction in patients who have ICA stenosis associated with hemodynamic compromise, if the ICA is satisfactorily dilated.

Aged↗
PubMed1995

[Effects on cognitive function and activities of daily living after stereotactic thalamotomy for Parkinson's disease].

Stereotactic thalamotomy was performed in ten patients with Parkinson's disease for the suppression of their tremor. After VL-thalamotomy, contralateral tremor and rigidity disappeared or was significantly reduced. Activities of daily living (ADL) measured by functional independence measure and Parkinson's disability score were improved postoperatively in all patients. There was significant improvement in anxiety index. However, other neuropsychological tests showed no significant change postoperatively. ADL improved after thalamotomy. It is concluded that stereotactic VL-thalamotomy is a useful treatment which improves ADL without cognitive dysfunction.

Activities of Daily Living↗
PubMed1995

[Amnestic syndrome after right temporo-occipital subcortical hemorrhage].

A case of right temporo-occipital subcortical hemorrhage with amnestic syndrome was reported. A 65-year-old woman presented with visual disturbance and headache. CT and MRI demonstrated a hemorrhagic lesion in the right occipital lobe involving parahippocampal gyrus. Neurological examination on admission revealed left homonymous hemianopsia and anterograde and retrograde amnesia. Neuropsychological examination revealed marked recent memory disturbance, but she had visual retention and verbal retention, and her value in WAIS (Wechsler Adult Intelligence Scale) was normal. After 40 days, she was discharged without improvement of amnesia. These findings suggest that the cortico-medial temporal lobe pathway was disturbed by subcortical hemorrhage, and we think there are connective fibers between visual and verbal memory systems. This is the first report of hippocampal amnesia following temporo-occipital subcortical hemorrhage.

Aged↗