A case of strategic-infarct mild cognitive impairment.
BACKGROUND
Although poststroke dementia has been investigated, patients with mild cognitive impairment (MCI) after stroke have received less attention, especially if there is cognitive decline in the absence of focal stroke symptoms.


METHODS
We report an 80-year-old female referred to our memory clinic with a 6-month history of amnestic symptoms. Neuropsychological evaluation demonstrated a marked decline in short-term memory, without anosognosia, aphasia, motor deficit, or sensory disturbance. A brain magnetic resonance imaging performed 2 months after the onset of her symptoms revealed a lacunar infarction in the genu of the right internal capsule extended to the anterior thalamus. This lesion had not been present in a previous magnetic resonance imaging obtained 2 months before her amnestic symptoms appeared.


CONCLUSIONS
The patient reported here demonstrated the evolution of MCI in the setting of a newly emergent lacunar infarction in the genu of the right internal capsule extended to the anterior thalamus. One possible mechanism for amnestic symptoms from a lacunar infarct in this location might be thalamocortical disconnection leading to "strategic-infarct MCI."
Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan. hide@dokkyomed.ac.jp
Hideaki
H
Tanaka
Yuya
Y
Hoshino
Yuka
Y
Watanabe
Kunihiko
K
Sakurai
Hidehiro
H
Takekawa
Koichi
K
Hirata
D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D059409:Stroke, Lacunar / Q000150:complications* / Q000473:pathology*; D015899:Tomography, Emission-Computed, Single-Photon