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Neuropsychiatr Dis Treat. 2013;9:937-40. doi: 10.2147/NDT.S43527. Epub 2013 Jul 3.

Acute parietal lobe infarction presenting as Gerstmann's syndrome and cognitive decline mimicking senile dementia.

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Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center.


Gerstmann's syndrome encompasses the tetrad of finger agnosia, agraphia, acalculia, and right-left confusion. An elderly man with a history of several cardiovascular diseases was initially brought to the psychiatric outpatient department by his family because of worsening of recent memory, executive function, and mixed anxious-depressive mood. Gerstmann's syndrome without obvious motor function impairment and dementia-like features could be observed at first. Emergent brain computed tomography scan revealed new left-middle cerebral artery infarction over the left posterior parietal lobe. This case reminds us that acute cerebral infarction involving the parietal lobe may present as Gerstmann's syndrome accompanied by cognitive decline mimicking dementia. As a result, emergent organic workups should be arranged, especially for elderly patients at high risk for cerebral vascular accident.


Gerstmann’s syndrome; dementia; parietal lobe infarction

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