Somesthetic disconnection syndromes were investigated in relation to the sites of lesions in the corpus callosum in 3 patients with callosal lesions, in order to identify the callosal regions responsible for the interhemispheric transfer of somesthetic information. Cases 1 and 2 with lesions in the posterior truncus exhibited transfer deficits of discriminative sensations between the left and right hands, left-sided tactile anomia and left-sided somesthetic alexia. Case 3 with lesions in the posteroventral part of the posterior truncus showed no signs of somesthetic disconnection syndromes. The results suggest the importance of the anterior and/or dorsal part of the posterior truncus of the corpus callosum for interhemispheric transfer of the discriminative sensations and integrated somesthetic information necessary for tactile naming and somesthetic reading.
"Crossed homonymous hemianopia" and "crossed left hemispatial neglect" were observed in a woman with Marchiafava-Bignami disease. Two forms of "crossed homonymous hemianopia" were observed. Initially, Goldmann perimeter testing showed a left homonymous hemianopia with the right hand and vice versa. Later, confrontation tests showed a left homonymous hemianopia, whereas visual field testing using the Goldmann perimeter (kinetic quantitative perimeter) and the OCTOPUS (Interzeag AG, static automated perimeter) showed a right homonymous hemianopia with either hand. "Crossed left hemispatial neglect" was not seen with the left hand, but neglect of the left hemifield was seen with the right hand. CT and MRI showed a lesion occupying almost the entire corpus callosum. PET showed no significant differences between comparable areas of the left and right cerebral hemispheres. These findings indicate that both signs of interhemispheric disconnection were due to the callosal lesion. Moreover, the "crossed left hemispatial neglect" can be explained as being a consequence of the dominance of the right cerebral hemisphere for visuospatial recognition.
A case of tuberculous brain infection following tuberculous meningitis in a 67-year-old man is presented. It was located in an old cerebral infarct associated with left internal carotid artery occlusion. CT demonstrated capsule enhancement in the left temporal area after iodinated contrast medium. Chemotherapy with INH, RFP and SM diminished the lesion and the capsule disappeared thirteen months later. It is suggested that a relatively long clinical history together with the appearance of a thick-walled abscess-like lesion on the CT scan is consistent with the diagnosis of tuberculous brain infection, perhaps an abscess.
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