Abstract
A 55-year-old right-handed male was admitted with mutism and right lower extremity weakness. In the chronic phase, pathologic grasping phenomenon of the right hand, intermanual conflict caused by the right-hand interference and transcortical motor aphasia were observed. MRI demonstrated several tiny, speckled lesions in the deep white matter of the left anterior cingulate gyrus and the corpus callosum. Cerebral angiography revealed occlusion of the left internal carotid artery with collateral circulation from the right internal carotid and basilar arteries. IMP-SPECT showed decreased blood flow in the left internal carotid artery distribution. Four similar cases characterized by intermanual conflict caused by the right-hand interference and transcortical motor aphasia have been reported previously. Our case and these literature cases share some features, i. E., right-handedness, pathologic grasping phenomenon of the right hand, responsible lesions in the left anterior artery territory, initial symptoms and favorable outcome, in addition to intermanual conflict caused by the right-hand interference and transcortical motor aphasia. These findings suggest these cases might be regarded as a unique syndrome characterized by two symptoms : intermanual conflict caused by the right-hand interference and transcortical motor aphasia.
