title: Isolated astasia manifested by acute infarct of the anterior corpus callosum and cingulate gyrus.
abstract: Astasia, the inability to stand and walk, in the absence of weakness or ataxia, is uncommon and unique. This syndrome is easy to misdiagnose as vestibulocerebellar disease. We report a patient with anterior callosal and cingulate infarction presenting as isolated astasia. A 65-year-old hypertensive man was admitted to our hospital with marked truncal instability. On neurological examination, he was unable to stand and walk independently. When asked to stand up from a sitting position, he had to grasp something nearby to propel himself upwards, and could not use his axial muscles. He collapsed when support was withdrawn. The patient showed no signs of amnesia, aphasia, apraxia or hemiasomatognosia. Diffusion weighted imaging at 3days after onset demonstrated an acute infarct in the anterior part of the right-sided corpus callosum and cingulate gyrus. Magnetic resonance angiography revealed an occlusion of the right anterior cerebral artery. We discuss the possible mechanisms of astasia due to anterior callosal and cingulate infarction.
authors.affiliation: Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China.
authors.forename: Shihui
authors.initials: S
authors.lastname: Xing
authors.affiliation: Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China.
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China.
authors.forename: Hongbing
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Dang
authors.affiliation: Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Neurology, Guangzhou No. 8 People's Hospital, Guangzhou Medical University, Guangzhou, China.
authors.forename: Chuo
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China. Electronic address: zengjs@pub.guangzhou.gd.cn.
authors.forename: Jinsheng
authors.initials: J
authors.lastname: Zeng
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000150:complications* / Q000473:pathology; D003337:Corpus Callosum / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000473:pathology; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D008297:Male
keywords: Astasia; Cingulate gyrus; Corpus callosum; Infarction