A Strategic Infarct Leading to Mild Cognitive Impairment
This case demonstrates that a strategic placed single small subcortical infarct can lead to significant cognitive impairment, in this case dysphasia resulting from a thalamic infarct. It is quite possible that a more detailed cognitive assessment by a neuropsychologist would have revealed other more subtle defects in cognitive function, given that the Montreal Cognitive Assessment is a screening tool and is not intended to be diagnostic. More extensive cognitive impairment can arise from such strategic placed infarcts particularly if they are bilateral e.g. when bilateral thalamic infarction occurs as a result of occlusion of a normal anatomical variant artery in which a single common perforating branch of the tip of the basilar artery supplies both thalami. Such strategic thalamic infarcts are recognized to cause of up to 5 % of cases of vascular dementia.
KeywordsSubcortical infarct Mild cognitive impairment Dysphasia Thalamus Vascular dementia
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