UNILATERAL LENTICULAR INFARCTS - RADIOLOGICAL AND CLINICAL SYNDROMES,ETIOLOGY, AND PROGNOSIS

Objectives-To analyse the clinical features induced by lenticular infa rction found in 20 patients, and to analyse the radiological and clini cal correlations. Methods-Eight women and 12 men, mean age 73 years, w ere included in this study, which was carried out from 1 January 1994 to 30 November 1996. They were characterised by the onset of a lenticu lar infarction, shown by CT and MRI. A complete neurological and neuro cognitive examination, and photon emission computed tomography (SPECT) , were performed in all the patients and there was a long clinical fol low up. Results-Two distinct clinical syndromes were identified corres ponding to the two anatomical areas of the lenticular nucleus: behavio ural and cognitive disorders were associated with infarcts within the globus pallidus, whereas both motor disorders (dystonia) and cognitive disorders were associated with infarcts within the putamen. Outcome w as excellent in all the patients for motor function, but slight cognit ive disorders, problems with short term memory, and dysphasia persiste d for several months. The size of the lesion did not explain these sym ptoms. By contrast, the slight reduction in cerebral blood flow found in the adjacent frontotemporal area may explain them by a deafferentat ion or a diaschisis phenomenon. Conclusion-It is possible to identify the clinical symptoms of a single lesion in the pallidus nucleus and i n the putaminal nucleus, in which behavioural, cognitive, and movement s disorders are important. After an acute and spectacular onset, outco me is in general excellent. A disease of the small arteries must be in volved.