K Gunasekaran

Abstract

Artery of Percheron is a rare anatomical variant of thalamic vascular supply. Stroke involving this vasculature is an uncommon event. Occlusion of this vessel produces a peculiar pattern in the form of bilateral thalamic infarcts with or without midbrain infarction. This results in variable clinical features ranging from somnolence or altered sensorium to coma in affected individuals, accompanied by characteristic neurological manifestations. Diagnosis of artery of Percheron infarction at the initial presentation may be difficult as it is infrequent and early neuroimaging studies may be negative. Here we report a patient, a case of AOP infarct whose MRI brain and clinical picture demonstrated the characteristic features. Keywords: Artery of Percheron, Ischemic stroke, Thalamus, Magnetic resonance Imaging.

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Abstract

Introduction: Cerebellum is involved not only in motor but also in behavioral and cognitive functions. Cerebellar contribution to non-motor functions has been supported by several animal, human and functional neuroimaging studies. Aim: The aim of this study was to explore the role of the cerebellum in cognition in patients with cerebellar disorders and to compare with healthy controls. Materials and Methods: It is Case Control study. 30 cases with cerebellar lesions due to vascular, degenerative, and post infective cause and 30 controls matched for age, sex, and years of education were chosen. International Cooperative ataxia rating scale(ICARS) used to quantify cerebellar dysfunction and Neuropsychological assessment was performed with Rey’s Complex Figure Test, Trial Making Test, Rey’s Auditory Verbal Learning Test, Stroop Interference Test, Digit span tests, Controlled Oral Word association Test, and Animal Naming Test. Statistics Analysis: Measures of central tendency and dispersion, tests of significance used for statistical analysis (SPSS version 21.0) Results: Cases showed deficits in executive function, verbal memory, fluency and attentional processes. Further analysis revealed that cases with bilateral degenerative cause were in general more impaired than those with unilateral vascular lesions. Conclusion: Altogether, this study confirms that cerebellar damage is associated with significant cognitive impairments. These deficits are correlated with an overall moderate impact on patient’s autonomy. Our data favour an indirect participation of the dorsolateral prefrontal and posterior parietal cortical areas to the cerebrocerebellum circuit. Keywords: Cerebellum, Cognition, ICARS-International Cooperative Ataxia Rating Scale, Neurocognitive Dysfunction

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Abstract

Fahr’s disease refers to sporadic or familial idiopathic basal ganglia calcification that is associated with many neurological, psychiatric and cognitive abnormalities. We report a case of Fahrs disease in a 25year old man who presented to us with generalized tonic clonic seizure and behavioral abnormalities. Clinical examination did not show any abnormal physical findings. The CT scan of brain showed multiple, symmetric and extensive calcifications in the basal ganglia, thalamus, and dentate nucleus, subcortical white matter of cerebral and cerebellar areas. Presently the patient is under follow up with good seizure control with phenytoin and sodium valproate. Keywords: Basal ganglia, Calcification, Fahr’s disease, Seizure.

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