Musician developed left putaminal hemorrhage and lost absolute pitch ability-case report.

Absolute pitch (AP) recognizes and labels the pitch chroma of a given tone without external reference. Its neural mechanism remains unclear. We report a 68-year-old AP musician who developed a left putaminal hemorrhage edematous lesion under the posterior insular cortex. Diffusion tensor tractography with the region of interest, including Heschl's gyrus, was performed. In the left hemisphere, the middle longitudinal fasciculus was absent, especially at the parietal lobe. Her AP ability was lost. As the hematoma was absorbed and the left MdLF was observed on the tractography, her AP ability recovered. Our case suggested that the left middle longitudinal fasciculus, a part of the ventral auditory pathway, plays a role in AP.

On-Road Driving Assessment in a Driving School Course and the Results of a Cognitive Function Test After Stroke in a Depopulated Rural Area in Japan: Case Series of Eight Patients.

Introduction Returning to driving after a stroke is a step toward independence and improving quality of life. Cognitive function after stroke is one of the essential factors that affect driving ability, and on-road driving assessment in driving school courses is beginning to spread in Japan. We started on-road driving assessment in 2018, and we herein report eight patients who underwent on-road driving assessment in the last three years, presenting both off-road cognitive function tests and on-road driving assessment results. Methods Of the 320 consecutive stroke patients from 2018 to 2020, we retrospectively investigated the eight patients' characteristics who underwent on-road driving assessment. We performed cognitive function tests, including behavioral inattention test (BIT), trail-making test, Wechsler Adult Intelligence Scale-III, and behavioral assessment of the dysexecutive syndrome. Patients who meet BIT > 35, at least three other subitem criteria, and no unevaluable subitems can undergo on-road driving assessment by a driving instructor. With the recommendation of the driving instructors, we comprehensively decided the permission to drive. Results All eight patients could return to driving after on-road driving assessment. Two patients could return to driving after nearly a year. Conclusion The patients did not meet all the cut-offs of the cognitive function test, but they were judged to return to driving by driving instructors. We finally permitted all eight patients to drive. On-road driving assessment in the driving school course might be helpful for determining the permission to return to driving.