Dyscalculia, Dysgraphia, and Left-Right Confusion from a Left Posterior Peri-Insular Infarct
The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalcul...
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| Published in: | Behavioural neurology Vol. 2014; no. 2014; pp. 1 - 4 |
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| Main Authors: | , , |
| Format: | Journal Article |
| Language: | English |
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Cairo, Egypt
Hindawi Puplishing Corporation
01-01-2014
Hindawi Publishing Corporation Hindawi Limited |
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| Abstract | The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI) showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation. |
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| AbstractList | The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI) showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation. |
| Author | Bhattacharyya, S. Klein, J. P. Cai, X. |
| AuthorAffiliation | 4 Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA 3 Harvard Medical School, Boston, MA 02115, USA 2 Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA 1 Department of Neurology, Brigham and Women's Hospital, 45 Francis Street, Boston, MA 02115, USA |
| AuthorAffiliation_xml | – name: 3 Harvard Medical School, Boston, MA 02115, USA – name: 1 Department of Neurology, Brigham and Women's Hospital, 45 Francis Street, Boston, MA 02115, USA – name: 2 Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA – name: 4 Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA |
| Author_xml | – sequence: 1 fullname: Bhattacharyya, S. – sequence: 2 fullname: Cai, X. – sequence: 3 fullname: Klein, J. P. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24817791$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_neuropsychologia_2019_06_001 crossref_primary_10_1590_1980_57642016dn11_020013 crossref_primary_10_3389_fnhum_2023_1100683 crossref_primary_10_1136_bcr_2020_238098 crossref_primary_10_1016_j_ajem_2018_06_038 crossref_primary_10_3389_fpubh_2020_00469 crossref_primary_10_2169_internalmedicine_0251_17 crossref_primary_10_1590_1980_57642016dn11_040018 |
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| Contributor | Cai, X Klein, J. P |
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| Copyright | Copyright © 2014 S. Bhattacharyya et al. Copyright © 2014 S. Bhattacharyya et al. S. Bhattacharyya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2014 S. Bhattacharyya et al. 2014 |
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| SubjectTerms | Aged Agraphia - etiology Agraphia - pathology Agraphia - psychology Brain Infarction - complications Brain Infarction - pathology Brain Infarction - psychology Case Report Dyscalculia - etiology Dyscalculia - pathology Dyscalculia - psychology Female Functional Laterality - physiology Humans Magnetic Resonance Imaging Parietal Lobe - pathology Perceptual Disorders - etiology Perceptual Disorders - pathology Perceptual Disorders - psychology Space Perception - physiology Temporal Lobe - pathology |
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| Title | Dyscalculia, Dysgraphia, and Left-Right Confusion from a Left Posterior Peri-Insular Infarct |
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