孤立性の自発性交錯を呈した中隔二前頭脳梗塞

Mesial bifrontal stroke presenting as isolated spontaneous confabulations.

• Vardan Nersesjan
• Henrik Gutte Bogwardt
• Daniel Kondziella

抄録

発作性心房細動を呈した52歳男性が，自発性混乱，作業記憶障害，前頭解放徴候を呈した．脳のMRスキャンでは前頭中隔虚血性脳梗塞が認められ，血管造影では両前大脳動脈は左内頸動脈から供給されていた．孤立性の自然交錯は脳卒中のまれな症状であり、前頭前野眼窩病変と関連している可能性がある。興味深いことに、急速眼球運動睡眠時の機能画像診断では、両側の内側前頭葉の代謝低下が認められ、夢を見ていることと、この患者の自発性交錯の奇妙な内容が解剖学的に重複していることが示唆された。

A 52-year-old man with paroxysmal atrial fibrillation presented with spontaneous confabulation, working memory deficits, and frontal release signs. MR scan of brain showed bifrontal mesial ischaemic strokes and angiography demonstrated that both anterior cerebral arteries were supplied by the left internal carotid artery. Isolated spontaneous confabulation is a rare presentation of stroke and may be associated with orbitofrontal cortex lesions. Interestingly, functional imaging during rapid-eye-movement sleep may show bilateral medial frontal lobe hypometabolism, suggesting anatomical overlap between dreaming and the bizarre content of this patient's spontaneous confabulation.

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