Apraxia and the Fetal Posterior Cerebral Artery. Case presentation

Authors

Keywords:

Kinetic apraxia, posterior cerebral artery of fetal origin, atherothrombotic cerebral infarction.

Abstract

Introduction: Apraxia is a group of non-paralytic disorders of motor function, where the person loses the ability to execute learned voluntary movements, without significant muscle weakness. It has been related to lesions of the frontal and parietal lobes. The most frequent causes are: vascular, tumors, and trauma, the first being the most prevalent in our environment. The middle cerebral artery is responsible for supplying these structures.

Objective: To highlight the importance of clinical findings and complementary tests in the topographic and etiological diagnosis of stroke.

Clinical case: Here, we report the case of a 68-year-old man suffering from hypertension, diabetes and dyslipidemia who presented a picture of left hemiparesis, kinetic apraxia, and homonymous hemianopsia; a neurological focus that usually corresponds to and is attributed to the vascular territory of the middle cerebral artery of the right hemisphere, associated with absence of flow in the homonymous proximal internal carotid artery and evidenced by Doppler.

Conclusions: Strokes from the fetal posterior cerebral artery territory can clinically mimic the middle cerebral artery and present with an apraxic disorder as a cardinal manifestation; hence the importance of a careful review of the complete neuroimaging study in all cases.

Downloads

Download data is not yet available.

References

1. Brazis PW, Masdeu J, Biller J. Localization in clinical Neurology. 7 ed. Philadelphia: Wolters Kluwer Lippincot Williams & Wilkins; 2017.

2. Ropper AH, Samuels MA, Klein JP. Adams y Victor: Principios de Neurología. México: McGraw Hill Medical; 2017.

3. Caplan LR. Basic pathology, anatomy, and pathophysiology of stroke. En su: Caplan’s Stroke: A Clinical Approach. 4 ed. Philadelphia: Saunders Elsevier; 2009. pp. 22.

4. Iqbal S. A comprehensive study of the anatomical variations of the circle of willis in adult human brains. J Clin Diagn Res. 2013; 7(11):2423-7.

5. Kim JS, Caplan LR, Wong KS. Clinical Stroke Syndromes. Front Neurol Neurosci. 2016; 40: 72-92.

6. Jankovic J, Mazziotta JC, Pomeroy SL, Daroff RB. Bradley’s Neurology in Clinical Practice. 7 ed. Philadelphia: Elsevier; 2015.

7. Caplan LR, ed. Stroke: Clinical Approach. Cambridge: Cambridge University Press; 2016.

8. Southerland AM. Clinical evaluation of the patient with acute stroke. Continuum (Minneap Minn) [Internet]. 2017 [Citado 02/06/2022];23(1, Cerebrovascular Disease):40-61. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28157743/

9. Pérez-Lázaro C, Santos-Lasaosa S, Garcés-Redondo M, Piñol-Ripoll G, Fabre-Pi O, Mostacero-Miguel E, et al. Ictus amnésico por infarto hipocampal. Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa. Rev Neurol [Internet]. 2005 [Citado 02/06/2022]; 41:27-30. Disponible en. https://www.neurologia.com/articulo/2004220

10. Iglesias Mohedano AM, García Pastor A, Díaz Otero F, Vázquez Alen P, Vales Montero M, Luque Buzo E, et al. Efficacy of New Measures Saving Time in Acute Stroke Management: A Quantified Analysis. Journal of Stroke and Cerebrovascular disease [Internet]. 2017 [Citado 02/06/2022]; 26(8):1817-1823. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28522232/

11. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Ass [Internet] Stroke. 2019 [Citado 02/06/2022]; 50(12). Disponible en: https://www.ahajournals.org/doi/10.1161/STR.0000000000000211

Published

2023-10-13

How to Cite

1.
Martinez Chile A, Santos-Martinez A, Esteban-Garcés EJ. Apraxia and the Fetal Posterior Cerebral Artery. Case presentation. Rev haban cienc méd [Internet]. 2023 Oct. 13 [cited 2025 Jul. 1];22(3):e5341. Available from: https://revhabanera.sld.cu/index.php/rhab/article/view/5341

Issue

Section

Clinical and pathological sciences