Difficulty in Matching Tools and their Recipients after Left Frontal and Parietal Infarction : A Case Report

Abstract

  We present a patient who developed difficulty of tool use following infarction in the left frontal and parietal regions. He made errors only in matching tools and their recipients in his daily life and testing situations. If a pair of a tool and its recipient are given, the patient has no problem handling the tool. He preserved the memory of the toolsʼ names, the understanding of pantomimes using these tools, and knowledge about the structure of tools. However, he failed in the task of choosing an appropriate recipient for a given tool, and the task of choosing an appropriate tool for a given object. Some of his exhibited behaviors were considering all options, stating “I do not know,” and thinking hard. Failure in matching the tool and its recipient was apparent in testing using any sort of representations, including real items, line drawings, and characters. These results pointed to the possibility of this impairment being associated with access to the patientʼs semantic memory. Based on the observed characteristics of the impairment, we suggested to his family members to reduce options within his range of vision. As a result, the patientʼs issue with tool use decreased, thereby reducing the burden on caregivers.