Korsakoff症候群を合併した後頭葉梗塞の神経放射線学的検討

Abstract

Korsakoff's syndrome is characterized by impairment of recent memory, disorientation and confabulation, and is now thought to be caused by bilateral damage of the Papez circuit. We conducted neuroradiological study of occipital infarction with Korsakoff's syndrome. CT findings allowed us to divide the cases into two groups. Group 1 (bilateral type) showed bilateral occipital infarction on CT, severe stenosis of the basilar bifurcation on angiography, and is clinically associated with Korsakoff's syndrome and cortical blindness. Differential diagnosis of this condition from Anton's syndrome should be made by confirming whether there is dementia or not. Group 2 (unilateral type) showed left occipitotemporal infarction on CT, obstruction of the left P₁ portion on angiography, and in clinically associated with Korsakoff's syndrome, right homonymous hemianopsia, right hemiplegia and right hemisensory disturbance. From the point of pathogenesis, Korsakoff's syndrome is caused by infarction of the bilateral mamillary body in Group 1, and the left mamillary body and hippocampus in Group 2. We point out that Korsakoff's syndrome will occur by unilateral damage of the Papez circuit on the dominant side.