Gnanashanmugam, G (2011) A Study on Evaluation of Motor, Cognitive and Behavioral Manifestations of Basal Ganglia Infarcts. Masters thesis, Madras Medical College, Chennai.
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Abstract
Isolated basal ganglia infarcts are rare. Basal ganglia infarcts are often associated with infarcts in other structures like cerebral cortex, thalamus and fronto parietal white matter. Clinical consequences of basal ganglia infarcts are often masked by infarcts in other areas. When basal ganglia infarct extends into the adjacent internal capsule, more concern and priority will be given to the hemiplegia and associated behavioral and cognitive features may be overlooked. Several studies have been conducted to analyze the clinical consequences of isolated basal ganglionic infarcts. Most of the studies were conducted in several countries outside India. So, we decided to analyze the clinical consequences of isolated basal ganglia infarcts in our patient population. Normal functions of many neurological structures were identified by the consequences of destruction of these structures. The pathologies that damage the human brain are rarely restricted to single anatomical structures. Stroke, trauma and tumour do not respect functional anatomical boundaries. Modern imaging techniques such as CT and MRI have dramatically improved the demonstration of the extent of brain damage caused by many pathologies. Of course, such techniques do not establish the full extent of anatomical pathology, and even more importantly do not show the distant functional effects (diaschisis) of such lesions. Motor, cognitive and behavioral consequences of basal ganglia infarcts are more common than expected. The current concepts of basal ganglia organization and physiology do not fully explain the disorders observed in man when the striatum and globus pallidus are damaged by crude pathology like infarction. In our study, dystonia was the most common movement disorder observed in patients with basal ganglionic infarcts, followed by chorea. Mild to moderate depression and apathy is very common in basal ganglionic infarcts; it should be identified and treated effectively to improve the quality of life. Reduced attention span, impaired verbal memory recall and executive dysfunction was the common cognitive impairments identifies which signifies the important role of frontal basal ganglionic subcortical circuitry in higher cognition like executive function and basic cognition like attention and memory. Patients with caudate infarcts developed more of behavioral and cognitive abnormalities like apathy and executive dysfunction than movement disorders except chorea. Patients with infarcts in the lentiform nucleus developed movement disorders frequently; behavioral disorders were rare in these patients. While infarcts in the basal ganglia are producing behavioral and movement disorders, many more cases with basal ganglia infarcts are encountered in which similar lesions have no such effects. The reasons for such discrepancies are unknown, but challenge simplistic concepts of basal ganglia motor physiology.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Motor ; Cognitive ; Behavioral Manifestations ; Basal Ganglia Infarcts. |
| Subjects: | MEDICAL > Neurology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 28 Jun 2017 11:49 |
| Last Modified: | 28 Jun 2017 11:49 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/580 |
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