A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke
Gerstmann Syndrome is a rare neurological presentation due to a lesion in the left dominant parietal lobe, manifesting as a tetrad of agraphia, acalculia, finger agnosia and right-left disorientation. We present a case of a 52-year-old man, right handdominant, who presented to the Emergency Depart...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Pusat Perubatan Universiti Kebangsaan Malaysia
2022
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| Online Access: | http://journalarticle.ukm.my/19678/ http://journalarticle.ukm.my/19678/1/22_ms0430_pdf_20213.pdf |
| _version_ | 1848814903432839168 |
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| author | Siti Nur Izni SMA, Kevin WCS, Ahmad Khaldun Ismail, |
| author_facet | Siti Nur Izni SMA, Kevin WCS, Ahmad Khaldun Ismail, |
| author_sort | Siti Nur Izni SMA, |
| building | UKM Institutional Repository |
| collection | Online Access |
| description | Gerstmann Syndrome is a rare neurological presentation due to a lesion in the left
dominant parietal lobe, manifesting as a tetrad of agraphia, acalculia, finger agnosia
and right-left disorientation. We present a case of a 52-year-old man, right handdominant, who presented to the Emergency Department with acute confusion for
one day. He was disorientated to time, place and person. Focused neurological
examination revealed atypical signs of acute stroke, comprising agraphia,
acalculia, finger agnosia and right-left disorientation. Stroke protocol was activated
and he underwent computed tomography brain perfusion, which confirmed
a large penumbra area at the left middle cerebral artery territory. Computed
tomography angiogram of the carotid arteries showed a long segment thrombosis
in the left internal carotid artery. Emergency thrombectomy was abandoned due
to impenetrable hard thrombus. He was treated with dual antiplatelet therapy
and discharged after three days with partial improvement in terms of following
commands, simple calculations and reduced finger agnosia. He was scheduled
for outpatient follow up. This case highlights Gerstmann syndrome as an atypical
manifestation of acute stroke. |
| first_indexed | 2025-11-15T00:41:29Z |
| format | Article |
| id | oai:generic.eprints.org:19678 |
| institution | Universiti Kebangasaan Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T00:41:29Z |
| publishDate | 2022 |
| publisher | Pusat Perubatan Universiti Kebangsaan Malaysia |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | oai:generic.eprints.org:196782022-09-12T03:21:31Z http://journalarticle.ukm.my/19678/ A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke Siti Nur Izni SMA, Kevin WCS, Ahmad Khaldun Ismail, Gerstmann Syndrome is a rare neurological presentation due to a lesion in the left dominant parietal lobe, manifesting as a tetrad of agraphia, acalculia, finger agnosia and right-left disorientation. We present a case of a 52-year-old man, right handdominant, who presented to the Emergency Department with acute confusion for one day. He was disorientated to time, place and person. Focused neurological examination revealed atypical signs of acute stroke, comprising agraphia, acalculia, finger agnosia and right-left disorientation. Stroke protocol was activated and he underwent computed tomography brain perfusion, which confirmed a large penumbra area at the left middle cerebral artery territory. Computed tomography angiogram of the carotid arteries showed a long segment thrombosis in the left internal carotid artery. Emergency thrombectomy was abandoned due to impenetrable hard thrombus. He was treated with dual antiplatelet therapy and discharged after three days with partial improvement in terms of following commands, simple calculations and reduced finger agnosia. He was scheduled for outpatient follow up. This case highlights Gerstmann syndrome as an atypical manifestation of acute stroke. Pusat Perubatan Universiti Kebangsaan Malaysia 2022-06 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/19678/1/22_ms0430_pdf_20213.pdf Siti Nur Izni SMA, and Kevin WCS, and Ahmad Khaldun Ismail, (2022) A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke. Medicine & Health, 17 (1). pp. 288-294. ISSN 2289-5728 https://www.medicineandhealthukm.com/toc/17/1 |
| spellingShingle | Siti Nur Izni SMA, Kevin WCS, Ahmad Khaldun Ismail, A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke |
| title | A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke |
| title_full | A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke |
| title_fullStr | A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke |
| title_full_unstemmed | A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke |
| title_short | A tetrad cognitive presentation of Gerstmann syndrome : a rare manifestation of stroke |
| title_sort | tetrad cognitive presentation of gerstmann syndrome : a rare manifestation of stroke |
| url | http://journalarticle.ukm.my/19678/ http://journalarticle.ukm.my/19678/ http://journalarticle.ukm.my/19678/1/22_ms0430_pdf_20213.pdf |