Left Parietal Tumors Presenting with Smartphone Icon Visual Agnosia: Two Cases of a Modern Presentation of Gerstmann Syndrome.

BACKGROUND: Gerstmanns syndrome-a clinical constellation of left-right confusion, finger agnosia, agraphia, and acalculia-is frequently attributed to pathology in the dominant inferior parietal lobe or temporo-occipital region. However, these unique clinical findings are often accompanied by more subtle signs, including aphasias, neglect, and agnosias. Associative visual agnosia, in which a patient is able to accurately perceive and describe but not recognize an object or symbol, is a well-documented but infrequently observed clinical entity. CASE DESCRIPTION: Here we detail 2 unique cases of patients who presented with the inability to recognize and use smartphone application icons. Both were found to have left temporo-occipital tumors displacing the left temporo-parietooccipital cortex. CONCLUSIONS: In the era of pervasive technology, we emphasize that smartphone icon associative visual agnosias may be recognized by discerning physicians in the clinical diagnosis of dominant parietal lobe pathology.

Agnosias visuales / Visual agnosia

Las agnosias visuales se definen como una alteración en la capacidad de reconocer objetos con la vista, en ausencia de pérdida de agudeza visual o disfunción cognitiva que explique esta alteración. Están producidas por lesiones de la corteza visual asociativa, respetando la corteza visual primaria. Existen 2 vías principales de procesamiento de la información visual: la vía ventral, encargada del reconocimiento de objetos, y la vía dorsal, encargada de su localización en el espacio. Las agnosias visuales pueden, por tanto, dividirse en 2 grandes grupos dependiendo de cuál de las 2 vías esté lesionada. El objetivo de este artículo es realizar una revisión narrativa sobre los diferentes síndromes agnósicos visuales, incluyendo los últimos avances realizados en algunos de ellos (AU)

Visual agnosia is defined as an impairment of object recognition, in the absence of visual acuity or cognitive dysfunction that would explain this impairment. This condition is caused by lesions in the visual association cortex, sparing primary visual cortex. There are 2 main pathways that process visual information: the ventral stream, tasked with object recognition, and the dorsal stream, in charge of locating objects in space. Visual agnosia can therefore be divided into 2 major groups depending on which of the two streams is damaged. The aim of this article is to conduct a narrative review of the various visual agnosia syndromes, including recent developments in a number of these syndromes (AU)

Resolution of diminished olfactory sensation after treatment of bilateral ophthalmic segment aneurysms with flow diversion: case report.

BACKGROUND AND IMPORTANCE: Olfactory tract dysfunction due to an unruptured intracranial aneurysm is rare. We present a case in which a patient with impaired olfaction related to bilateral internal carotid artery aneurysms experienced subjective and quantitative objective improvement of olfactory sensation after treatment of ophthalmic segment aneurysms with flow diversion. CLINICAL PRESENTATION: A 44-year-old woman presented with hyposmia and bilateral ophthalmic segment internal carotid artery aneurysms. The symptom of hyposmia, worsening over a period of several months, was suspected to be due to mass effect from bilateral unruptured ophthalmic segment aneurysms pressing on the olfactory tracts. Each aneurysm was treated with a Pipeline embolization device (PED). Follow-up angiography at 5 months showed occlusion of both aneurysms. The patient experienced subjective improvement in olfaction and complete objective resolution of her hyposmia as measured by the validated University of Pennsylvania Smell Identification Test (UPSIT). CONCLUSION: Intracranial aneurysms causing dysfunction of olfactory sensation due to mass effect upon the olfactory tract can be successfully treated with flow diversion. Flow diversion should be considered as one of the treatment options for patients with cranial nerve dysfunction due to unruptured intracranial aneurysms.

The surgical treatment of Landau-Kleffner syndrome.

The medical management of Landau-Kleffner syndrome is usually effective for seizure control and eventual seizure remission. However, the response for language and behavior is often poor. Surgery, in the form of multiple subpial transections (MSTs) to include Wernicke's area has been suggested as a way forward if electrophysiologic lateralization can be demonstrated. Surgical series in the literature are few and outcome from surgery variable.

Visuospatial deficits in children 3-7 years old with shunted hydrocephalus.

OBJECTIVE: To define non-verbal intelligence deficits in children 3-7 years of age following shunted hydrocephalus (HCP). DESIGN: Prospective randomised single-blinded study. Thirty shunted HCP (study) and 30 cardiac (control) patients between the ages of 3 and 7 years were compared on eight non-verbal subtests of the Junior South African Individual Scales (JSAIS). SETTING: Department of Neurosurgery at Wentworth Hospital, Durban, South Africa. RESULTS: Significant differences between the HCP and cardiac groups were recorded on all eight subtests of the JSAIS. The HCP group experienced problems with spatial orientation, perceptual planning and organisation, emotive deficits, abstract thinking and visual concepts. CONCLUSION: All patients with shunted HCP had specific deficiencies in defined cognitive areas of non-verbal intelligence when compared with the controls. Further studies are warranted to determine the effects of ventriculoperitoneal shunting on non-verbal intelligence so that the special educational needs of HCP children may be met.