DOCSLIB.ORG

Acalculia LESSON Description/Etiology Acalculia Is an Acquired Condition of Impaired Mathematical Ability Due to Brain Injury

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Acalculia LESSON Description/Etiology Acalculia Is an Acquired Condition of Impaired Mathematical Ability Due to Brain Injury QUICK Acalculia LESSON Description/Etiology Acalculia is an acquired condition of impaired mathematical ability due to brain injury. Acalculia often occurs as a result of traumatic brain injury (TBI), intracranial hemorrhage or infarction (i.e., stroke), lesions/tumors, and/or neurodegenerative conditions (e.g., dementia). Depending on the degree of impairment, acalculia can be an incapacitating condition. Math calculation is a complex process that involves verbal ability, spatial skills, memory, and executive function; impairment in one or more of these domains can result in acalculia. Signs and symptoms of acalculia are categorized in the four domains of transcoding impairment, impairment of a quantitative magnitude representation, oral and/or written calculation impairment, and impairment of conceptual mathematical thinking. One focus of current research is whether or not the type and severity of signs and symptoms are associated with the location of brain injury (see Food for Thought, below). Diagnosis of acalculia is made based on patient history, physical examination, and results of tests that measure cognitive function and number/mathematic processing. The Mini Mental State Exam (MMSE) can be administered to screen for overall cognitive impairment. Although there are many different tools that can be used to assess mathematic abilities, the only standardized neuropsychologic test for acalculia is the EC301 battery. Results of the EC301 battery can provide clinicians with an understanding of the overall severity of mathematic impairment and the specific areas in which the patient requires support. The ICD-9 EC301 evaluates number and mathematic processing in the following 13 functions: 784.69 › Counting (e.g., by ones or tens) › Dot counting ICD-10 R48.8 › Transcoding (e.g., from Arabic to alphabet code) › Recognition and transcription of arithmetic signs (e.g., +, -) on dictation › Number comparison (i.e., identifying which of two numbers is higher) Authors › Mental calculation Hillary Ittner, RN, MSN › Estimation of the result of a math problem Cinahl Information Systems, Glendale, CA › Writing a number in the correct place on an analogic scale Jennifer Kornusky, RN, MS Cinahl Information Systems, Glendale, CA › Writing a mathematic operation using the correct arithmetic signs › Performing a written calculation Reviewers › Estimation of quantity Eliza Schub, RN, BSN › Making a judgment about whether something is too little, enough, or too much depending Cinahl Information Systems, Glendale, CA on the given context Amy Hurst, RN, MSN Cinahl Information Systems, Glendale, CA › Numeric knowledge (e.g., the numbers of days of the week) Nursing Executive Practice Council Treatment of patients with acalculia is typically focused on managing the underlying brain Glendale Adventist Medical Center, Glendale, CA injury and associated complications. In some patients, mathematic ability spontaneously returns along with other indicators of cognitive function in the first few months after Editor injury. The likelihood of spontaneous recovery diminish with time; in patients with Diane Pravikoff, RN, PhD, FAAN sustained mathematic impairment, management focuses on long-termrehabilitation for Cinahl Information Systems, Glendale, CA retraining in basic arithmetic facts, calculation skills, and transcoding by a neuropsychology specialist, speech-language pathologist, and/or other clinician specialist in cognitive rehabilitation. Patient/family education and emotional support should be provided to February 10, 2017 Published by Cinahl Information Systems, a division of EBSCO Information Services. Copyright©2017, Cinahl Information Systems. All rights reserved. No part of this may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher. Cinahl Information Systems accepts no liability for advice or information given herein or errors/omissions in the text. It is merely intended as a general informational overview of the subject for the healthcare professional. Cinahl Information Systems, 1509 Wilson Terrace, Glendale, CA 91206 improve understanding of acalculia and its potential impact on quality of life, and to assist with coping. Facts and Figures The term acalculia was coined in 1919 by Salomon Henschen, a Swedish neurologist. Although the incidence of acalculia is unknown, there is a high incidence of math-related deficits in patients with neurologic dysfunction. Risk Factors Persons with TBI, neurodegenerative diseases, brain lesions/tumors, or stroke are at an increased risk of developing acalculia. Signs and Symptoms/Clinical Presentation Patients with acalculia have impairment in or complete loss of the ability to perform verbal or written mathematic tasks. Routine computations (e.g., making a transaction at a cash register, balancing a checkbook) can be extremely challenging or impossible for patients to perform. Many patients have impaired memory, attention, and language ability secondary to the underlying brain injury. Assessment › Patient History • Take a patient history, including asking about a brain tumor, stroke, TBI, or other cause of neurologic impairment • Ask about the onset, duration, and severity of signs and symptoms, including difficulty in attention, language, and memory › Physical Findings of Particular Interest • Neurologic examination can have normal results or indicate deficits secondary to the underlying brain injury › Laboratory Tests • No laboratory tests are performed to diagnose acalculia › Other Diagnostic Tests/Studies • MMSE indicates intact cognition if the patient scores > 25 points out of 30 • EC301 battery will be administered to evaluate varying levels of mathematical deficits Treatment Goals › Promote Cognitive and Memory Rehabilitation • Assess vital signs, mental status, and the impact of neurologic impairment on functional status and quality of life and review results of diagnostic testing. Report abnormal findings to the treating clinician and provide prescribed treatment • Follow facility protocols to support the patient’s recovery from brain injury (e.g., assist with ambulation and ADLs, maintain patient safety) • Request referral to a neuropsychology specialist, speech-languagepathologist, and/or cognitive rehabilitation specialist, as appropriate • As appropriate, encourage practice with mathematic drills of arithmetic facts, calculation skills, and transcoding › Promote Emotional Well-Being and Educate • Assess the anxiety level and coping ability of the patient/family, and for knowledge deficits about the diagnosis and management of acalculia; provide emotional support and patient/family education about acalculia and on components of the rehabilitative care plan • Request referral to a social worker to identify support groups for persons with brain injury and neurologic impairment, as appropriate Food for Thought › Acalculia should not be confused with dyscalculia, a developmental disorder of impaired numerical understanding that affects 3–6% of children › Aphasia (i.e., a communication impairment that is characterized by loss of expressive and receptive language skills) often occurs in conjunction with acalculia in persons with left-hemispheric lesions › Although acalculia in patients with right-hemisphere brain injury has generally been thought to be the result of visuo-spatial impairments, researchers in a study of 30 right-hemisphere damaged patients observed a higher rate of arithmetic errors than spatial errors (Benavides-Varela et al., 2016) Red Flags › Acalculia, which is an acquired disability, should be distinguished from dyscalculia, which is a learning disability that is identified in childhood What Do I Need to Tell the Patient/Patient’s Family? › Encourage family members to provide the patient with the appropriate level of support to complete tasks that require an understanding of mathematic concepts (e.g., counting money at a store, making bank transactions) › As appropriate, educate about the importance of continued medical surveillance, including cognitive rehabilitation by a clinical specialist › Educate the patient/family that Internet resources, educational information, and support groups are available (e.g., the Brain Injury Association of America at http://www.biausa.org/ or by calling 800-444-6443) › References 1. Ardila, A., & Rosselli, M. (2002). Acalculia and dyscalculia. Neuropsychology Review, 12(4), 179-231. doi:10.1023/A:1021343508573 2. Benavides-Varela, S., Pitteri, M., Priftis, K., Passarini, L., Meneghello, F., & Semernza, C. (2014). Right-hemisphere (spatial?) acalculia and the influence of neglect. Frontiers in Human Neuroscience, 8, 644. doi:10.3389/fnhum.2014.00644 3. Benavides-Varela, S., Piva, D., Burgio, F., Passarini, L., Rolma, G., Meneghello, F., & Semernza, C. (2016). Re-assessing acalculia: Distinguishing spatial and purely arithmetical deficits in right-hemisphere damaged patients. Cortex. Advance online publication. doi:10.1016/j.cortex.2016.12.014 4. Kucian, K., & von Aster, M. (2015). Developmental dyscalculia. European Journal of Pediatrics, 174, 1-13. doi:10.1007/s00431-014-2455-7 5. Pantelyat, A., Dreyfuss, M., Moore, P., Gross, R., Schuck, T., Irwin, D., & Grossman, M. (2011). Acalculia in autopsy-proven corticobasal degeneration. Neurology, 76(7 Suppl. 2), S61-S63. doi:10.1212/WNL.0b013e31820c34ca 6. Willmes, K. (2008). Acalculia. In G. Goldenberg, & B. L. Miller (Eds.), Handbook of clinical neurology (Vol. 88, pp. 339-358). Amsterdam: Elsevier..
Load more

Recommended publications
  • Systems Neuroscience of Mathematical Cognition and Learning
    CHAPTER 15 Systems Neuroscience of Mathematical Cognition and Learning: Basic Organization and Neural Sources of Heterogeneity in Typical and Atypical Development Teresa Iuculano, Aarthi Padmanabhan, Vinod Menon Stanford University, Stanford, CA, United States OUTLINE Introduction 288 Ventral and Dorsal Visual Streams: Neural Building Blocks of Mathematical Cognition 292 Basic Organization 292 Heterogeneity in Typical and Atypical Development 295 Parietal-Frontal Systems: Short-Term and Working Memory 296 Basic Organization 296 Heterogeneity in Typical and Atypical Development 299 Lateral Frontotemporal Cortices: Language-Mediated Systems 302 Basic Organization 302 Heterogeneity in Typical and Atypical Development 302 Heterogeneity of Function in Numerical Cognition 287 https://doi.org/10.1016/B978-0-12-811529-9.00015-7 © 2018 Elsevier Inc. All rights reserved. 288 15. SYSTEMS NEUROSCIENCE OF MATHEMATICAL COGNITION AND LEARNING The Medial Temporal Lobe: Declarative Memory 306 Basic Organization 306 Heterogeneity in Typical and Atypical Development 306 The Circuit View: Attention and Control Processes and Dynamic Circuits Orchestrating Mathematical Learning 310 Basic Organization 310 Heterogeneity in Typical and Atypical Development 312 Plasticity in Multiple Brain Systems: Relation to Learning 314 Basic Organization 314 Heterogeneity in Typical and Atypical Development 315 Conclusions and Future Directions 320 References 324 INTRODUCTION Mathematical skill acquisition is hierarchical in nature, and each iteration of increased proficiency builds on knowledge of a lower-level primitive. For example, learning to solve arithmetical operations such as “3 + 4” requires first an understanding of what numbers mean and rep- resent (e.g., the symbol “3” refers to the quantity of three items, which derives from the ability to attend to discrete items in the environment).
    [Show full text]
  • Children with Dyscalculia Show Hippocampal Hyperactivity During Symbolic Number Perception
    fnhum-15-687476 July 14, 2021 Time: 18:40 # 1 ORIGINAL RESEARCH published: 20 July 2021 doi: 10.3389/fnhum.2021.687476 Children With Dyscalculia Show Hippocampal Hyperactivity During Symbolic Number Perception Sertaç Üstün1,2,3, Nazife Ayyıldız2,3,4, Emre H. Kale4, Öykü Mançe Çalı ¸sır4,5, Pınar Uran6, Özgür Öner7, Sinan Olkun8 and Metehan Çiçek1,2,3,4* 1 Department of Physiology, Ankara University School of Medicine, Ankara, Turkey, 2 Neuroscience and Neurotechnology Center of Excellence, Ankara, Turkey, 3 Department of Interdisciplinary Neuroscience, Health Science Institute, Ankara University, Ankara, Turkey, 4 Brain Research Center, Ankara University, Ankara, Turkey, 5 Program of Counseling and Guidance, Department of Educational Sciences, Ankara University Faculty of Educational Sciences, Ankara, Turkey, 6 Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara, Turkey, 7 Department of Child and Adolescent Psychiatry, Bahçe ¸sehirUniversity School of Medicine, Istanbul,˙ Turkey, 8 Department of Mathematics Education, Final International University, Kyrenia, Cyprus Dyscalculia is a learning disability affecting the acquisition of arithmetical skills in children Edited by: Jonas Kaplan, with normal intelligence and age-appropriate education. Two hypotheses attempt to University of Southern California, explain the main cause of dyscalculia. The first hypothesis suggests that a problem United States with the core mechanisms of perceiving (non-symbolic) quantities is the cause of Reviewed by: dyscalculia (core deficit hypothesis), while the alternative hypothesis suggests that Hüseyin Akan, Ondokuz Mayıs University, Turkey dyscalculics have problems only with the processing of numerical symbols (access Roberto A. Abreu-Mendoza, deficit hypothesis). In the present study, the symbolic and non-symbolic numerosity Rutgers University–Newark, United States processing of typically developing children and children with dyscalculia were examined *Correspondence: with functional magnetic resonance imaging (fMRI).
    [Show full text]
  • Spatial Acalculia
    Intern. J. Neuroscience. 1994, Vol. 18, pp. 117-184 0 1994 Gordon and Breach Science Publishers S.A. Reprints available directly from the publisher Printed in the United States of America Photocopying permitted by license only SPATIAL ACALCULIA ALFRED0 ARDILA and MONICA ROSSELLI Miami Institute of Psychology, Miami, Florida, USA (Received June IS, 1994) Twenty-one patients with right hemisphere damage were studied (1 1 men, 10 women; average age = 41.33; range 19-65). Patients were divided into two groups: pre-Rolandic (six patients) and retro-Rolandic (15 patients) right hemisphere damage. A special calculation test was given. Different types of calculation errors were analyzed. Spatial alexia and agraphia for numbers, loss of calculation autornatisms, reasoning errors, and general spatial de- fects interfering with normal number writing and reading, were observed. Number processing was impaired, whereas the calculation system was partially preserved. Fact retrieval and procedural difficulties were observed, but arithmetical rules were properly used. It is concluded that calculation abilities in right hemisphere damaged patients are disrupted as a result of: (I) visuospatial defects that interfere with the spatial arrangement of num- bers and the mechanical aspects of mathematical operations: (2) inability to recall mathematical facts and appro- priately to use them; and (3) inability to normally conceptualize quantities and process numbers. Keywords: uculculiu. right hemisphere. Henschen ( 1925) introduced the term “acalculia” to refer to the impairments in mathemat- ical abilities in case of brain damage. Berger (1926) distinguished two different types of acalculia: primary and secondary acalculia. Secondary acalculia refers to a calculation de- For personal use only.
    [Show full text]
  • Journal of Neurological Disorders DOI: 10.4172/2329-6895.1000309 ISSN: 2329-6895
    olog eur ica N l D f i o s l o a r n d r e u r s o J Lee, et al., J Neurol Disord 2016, 4:7 Journal of Neurological Disorders DOI: 10.4172/2329-6895.1000309 ISSN: 2329-6895 Case Report Open Access Two Cases with Cerebral Infarction in the Left Middle Frontal Lobe Presented as Gerstmann's Syndrome Eun-Ju Lee, Hye-Young Shin, Young Noh, Ki-Hyung Park, Hyeon-Mi Park, Yeong-Bae Lee, Dong-Jin Shin, Young Hee Sung and Dong Hoon Shin* Department of Neurology, Gil Hospital, Gachon University Gil Medical Center, Incheon, South Korea *Corresponding author: Dong Hoon Shin, Department of Neurology, Gil Hospital, Gachon University Gil Medical Center, South Korea, Tel: +82-32-460-3346; Fax: +83-32-460-3344; E-mail: [email protected] Rec date: Oct 08, 2016, Acc date: Oct 18, 2016, Pub date: Oct 22, 2016 Copyright: © 2016 Lee, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Gerstmann's syndrome is a neuropsychological disorder characterized by four symptoms, namely, acalculia, finger agnosia, left-right disorientation, and agraphia suggesting the presence of a lesion in the inferior parietal lobule of the dominant hemisphere, especially at the angular gyrus. Several descriptions of Gerstmann's syndrome have been reported in associated with a lesion to the left frontal lobe, but none of these reports fulfilled the full tetrad of diagnostic criteria.
    [Show full text]
  • Transient Gerstmann Syndrome As Manifestation of Stroke Case Report and Brief Literature Review
    Dement Neuropsychol 2017 June;11(2):202-205 Case Report doi: 10.1590/1980-57642016dn11-020013 Transient Gerstmann syndrome as manifestation of stroke Case report and brief literature review Rafael Batista João1, Raquel Mattos Filgueiras2, Marcelo Lucci Mussi3, João Eliezer Ferri de Barros4 ABSTRACT. Gerstmann Syndrome (GS) is a rare neurological condition described as a group of cognitive changes corresponding to a tetrad of symptoms comprising agraphia, acalculia, right-left disorientation and finger agnosia. It is known that some specific brain lesions may lead to such findings, particularly when there is impairment of the angular gyrus and adjacent structures. In addition, the possibility of disconnection syndrome should be considered in some cases. The purpose of this article is to report a case of a young, cardiac patient, non-adherent to treatment, who presented with a stroke in which transient clinical symptoms were compatible with the tetrad of GS. The case report is followed by a discussion and brief review of the relevant literature. Key words: Gerstmann syndrome, disconnection syndrome, insular cortex, parietal lobe, frontal lobe. SÍNDROME DE GERSTMANN TRANSITÓRIA COMO MANIFESTAÇÃO DE ACIDENTE VASCULAR ENCEFÁLICO: RELATO DE CASO E BREVE REVISÃO DE LITERATURA RESUMO. A síndrome de Gerstmann (SG) é uma condição neurológica rara, caracterizada por um grupo de alterações cognitivas que correspondem a uma tétrade composta por agrafia, acalculia, desorientação direita-esquerda e agnosia para dedos. Sabe-se que certas lesões encefálicas específicas podem levar a tais achados, particularmente quando ocorre acometimento do giro angular e estruturas adjacentes. Além disso, a possibilidade de síndrome de desconexão deve ser considerada em alguns casos.
    [Show full text]
  • Acalculia and Dyscalculia
    Neuropsychology Review pp628-nerv-452511 November 23, 2002 8:23 Style file version sep 03, 2002 Neuropsychology Review, Vol. 12, No. 4, December 2002 (C 2002) Acalculia and Dyscalculia , Alfredo Ardila1 3 and M´onica Rosselli2 Even though it is generally recognized that calculation ability represents a most important type of cognition, there is a significant paucity in the study of acalculia. In this paper the historical evolution of calculation abilities in humankind and the appearance of numerical concepts in child development are reviewed. Developmental calculation disturbances (developmental dyscalculia) are analyzed. It is proposed that calculation ability represents a multifactor skill, including verbal, spatial, memory, body knowledge, and executive function abilities. A general distinction between primary and secondary acalculias is presented, and different types of acquired calculation disturbances are analyzed. The association between acalculia and aphasia, apraxia and dementia is further considered, and special mention to the so-called Gerstmann syndrome is made. A model for the neuropsychological assessment of numerical abilities is proposed, and some general guidelines for the rehabilitation of calculation disturbances are presented. KEY WORDS: acalculia; dyscalculia; numerical knowledge; calculation ability. INTRODUCTION Acalculia is frequently mentioned in neurological and neuropsychological clinical reports, but research di- Calculation ability represents an extremely complex rected specifically to the analysis of acalculia
    [Show full text]
  • Mathematical Learning Disability: Cognitive Conditions, Development
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bstract The purpose of the present thesis was to test and contrast hypotheses regarding the cognitive conditions that support the development of mathematical learning disability (MLD). The following hypotheses were tested in this thesis: a) the domain-general deficit hypothesis—the deficit is primarily localized to domain- general systems such as working memory; b) the number sense deficit hypothesis—the deficit is localized to the innate approximate number system (ANS), c) the numerosity coding deficit hypothesis—the deficit is localized to an exact number representation system, d) the access deficit hypothesis—the deficit occurs in the mapping between symbols and the innate number representation system (e.g., ANS) and e) the multiple deficit hypothesis—MLD is related to more than one deficit. Three studies examined the connection between cognitive abilities and arithmetic. Study one and three compared different
    [Show full text]
  • Acalculia by Alfredo Ardila Phd (Dr
    Acalculia By Alfredo Ardila PhD (Dr. Ardila of Florida International University has no relevant financial relationships to disclose.) Originally released March 10, 1998; last updated January 29, 2017; expires January 29, 2020 Introduction This article includes discussion of acalculia, acquired dyscalculia, anarithmetia, agraphic acalculia, alexic acalculia, aphasic acalculia, and spatial acalculia. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations. Overview Calculation ability represents a complex cognitive process. It has been understood to represent a multifactorial skill, including verbal, spatial, memory, and executive function abilities. Calculation ability is frequently impaired in cases of focal brain pathology, especially posterior left parietal damage, and dementia. Acalculia is also common in posterior cortical atrophy. Contemporary neuroimaging studies suggest that arithmetic is associated with activation of specific brain areas, specifically the intraparietal sulcus; language and calculation areas are partially overlapped and partially independent. Acalculia recovery is variable and depends on different factors, such as the extension and etiology of the brain pathology. Key points • Calculation ability represents a multifactorial skill including verbal, spatial, memory, and executive function abilities. • Calculation disturbances are usually observed in cases of posterior left parietal damage. • The intraparietal sulcus has been proposed to represent the most crucial brain region in the understanding and the use of quantities. • A major distinction can be established between primary and secondary acalculia. • Acalculia is most often caused by a stroke, tumor, or trauma and it is usually present in dementia. Historical note and terminology Henschen introduced the term "acalculia" to refer to the impairments in mathematical abilities in patients with brain damage (Henschen 1925).
    [Show full text]
  • Acalculia in Autopsy-Proven Corticobasal Degeneration
    Acalculia in Autopsy-Proven Corticobasal Degeneration Figure Imaging and pathologic features of corticobasal degeneration (A) Gross atrophy in parietal lobe (asterisk) of case 1. (B) Hematoxylin-eosin (H-E) preparation of the angular gyrus of case 1 at 10ϫ magnification showing significant neuronal dropout and gliosis in the superficial cortical layers. (C) PHF stain for tau in the cortex of the angular gyrus of case 1 at 60ϫ magnifica- tion showing balloon cells (arrow). (D) PHF stain for tau in the white matter of the angular gyrus of case 1 at 60ϫ magnification showing an astrocytic plaque (arrowhead). (E) T1 magnetization-prepared rapid gradient echo MRI sequence showing bilateral parietal-occipital atrophy in coronal (y ϭϪ60), sagittal (left hemisphere) (x ϭϪ47), and axial (z ϭϩ14) views of case 2. orticobasal degeneration (CBD) is a neurodegenerative condition presenting with an asymmetric extrapyramidal disorder, cortical sensory loss, and apraxia. While the original case descriptions men- Ctioned acalculia,1 few studies have investigated this,2,3 and reports of acalculia in autopsy-proven CBD are very rare. We detail 2 autopsy-defined CBD cases with acalculia to emphasize that CBD compromises cognitive functioning due to disease that includes parietal cortex. CASE REPORTS Case 1. A 72-year-old right-handed woman with hypertension and hypothyroidism was evaluated for progressive cognitive and motor difficulties over 3 years. She first noted writing difficulty. Her right hand began performing involuntary, semi-purposeful movements. She required increasing assistance dressing and cutting food. She misjudged spatial relationships while driving and cooking. She had several falls. Examination revealed Mini-Mental State Examination (MMSE) score of 27.
    [Show full text]
  • Toe Agnosia in Gerstmann Syndrome
    Journal of Neurology, Neurosurgery, and Psychiatry 1997;63:399–403 399 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.63.3.399 on 1 September 1997. Downloaded from SHORT REPORT Toe agnosia in Gerstmann syndrome Oliver Tucha, Anne Steup, Christian Smely, Klaus W Lange Abstract debate concerning the Gerstmann syndrome The following case report presents a has been described elsewhere.10 14–16 We de- patient exhibiting Gerstmann syndrome scribe a patient who had a focal lesion in the accompanied by toe agnosia. A 72 year old angular gyrus of the left hemisphere which was right handed woman had a focal lesion in caused by a glioblastoma multiforme. The the angular gyrus of the left hemisphere patient exhibited Gerstmann syndrome ac- which was caused by a glioblastoma companied by toe agnosia. multiforme. The first symptom she had complained of was severe headache. Case report Standardised neuropsychological tests of A 72 year old right handed woman who had intelligence, memory, attention, fluency, had no history of neurological or psychiatric apraxia, and language functions as well as diseases was admitted to the Department of tests for the assessment of agraphia, acal- Neurosurgery for treatment of a glioblastoma culia, right-left disorientation, and digit multiforme in the left parietal lobe. The first agnosia were performed. The patient symptom she had complained of was severe displayed all four symptoms of the Gerst- headache. The patient had worked as an accountant until the age of 64. mann syndrome—namely, agraphia, acal- copyright. culia, right-left disorientation, and finger A cranial CT scan disclosed a tumour agnosia.
    [Show full text]
  • Posterior Cortical Dementia with Alexia: Neurobehavioural, MRI, and Petfindings 445
    Journal ofNeurology, Neurosurgery, and Psychiatry 1991;54:443-448 4L43 Posterior cortical dementia with alexia: J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.54.5.443 on 1 May 1991. Downloaded from neurobehavioural, MRI, and PET findings L Freedman, D H Selchen, S E Black, R Kaplan, E S Garnett, C Nahmias Abstract The syndrome of posterior cortical demen- A progressive disorder of relatively focal tia (PCD) described by Benson et al'4 and De but asymmetric biposterior dysfunction Renzi' is clinically dominated by disturbances is described in a 54 year old right handed in visual function including object agnosia, male. Initial clinical features included prosopagnosia, alexia, and visuospatial dis- letter-by-letter alexia, visual anomia, orientation. The development of transcortical acalculia, mild agraphia, constructional sensory aphasia and a complete Gerstmann's apraxia, and visuospatial compromise. and Balint's syndrome was also present in Serial testing demonstrated relentless several patients. Computed tomography34 and deterioration with additional develop- MRI4 in PCD revealed prominent posterior ment of transcortical sensory aphasia, atrophy characterised by enlargement of the Gerstmann's tetrad, and severe occipital horns. However, the topography of visuoperceptual impairment. Amnesia cerebral metabolic dysfunction using positron was not an early clinical feature. Judg- emission tomography (PET) has yet to be ment, personality, insight, and aware- described for PCD. ness remained preserved throughout We examined a patient with serial neurobe- most of the clinical course. Extinction in havioural testing complimented by MRI and the right visual field to bilateral stimula- PET who exhibited PCD. The dementia was tion was the sole neurological abnor- notable for the presence of a severe letter-by- mality.
    [Show full text]
  • Neurocognitive Accounts of Developmental Dyscalculia and Its Remediation 12 T
    CHAPTER Neurocognitive accounts of developmental dyscalculia and its remediation 12 T. Iuculano1 Stanford Cognitive and Systems Neuroscience Laboratory, Stanford University School of Medicine, Palo Alto, CA, United States 1Corresponding author: Tel.: +1-650-736-0128; Fax: +1-650-736-7200, e-mail address: [email protected] Abstract Numbers are one of the most pervasive stimulus categories in our environment and an integral foundation of modern society. Yet, up to 20% of individuals fail to understand, represent, and manipulate numbers and form the basis of arithmetic, a condition termed developmental dys- calculia (DD). Multiple cognitive and neural systems including those that serve numerical, mnemonic, visuospatial, and cognitive control functions have independently been implicated in the etiology of DD, yet most studies have not taken a comprehensive or dynamic view of the disorder. This chapter supports the view of DD as a multifaceted neurodevelopmental disorder that is the result of multiple aberrancies at one or multiple levels of the information processing hierarchy, which supports successful arithmetic learning, and suggests that interventions should target all these systems to achieve successful outcomes, at the behavioral and neural levels. Keywords Developmental dyscalculia, Neurocognitive systems, Systems neuroscience, Development, Brain plasticity, Learning, Education 1 INTRODUCTION Developmental dyscalculia (DD) is a specific developmental learning disability characterized by difficulties in acquiring adequate arithmetical
    [Show full text]