Abstract
Sixty-nine-years-old hypertensive male was hospitalized for evaluation of severe disori-entation to place and memory loss. On the previous day, he was found at midnight by his wife that he became disoriented within his house and could not go to the bath-room from his bedroom.
For several years he had sometimes experienecd slight fainting spell during walk.
On admission, he was confused and was found slightly demented like Korsakoff's syndrome. There was disorientation to time and place. Especially as space (geographical) disorientation was severe, he could not find his way to the bath-room nor his own room at the ward. Recent memory and new learning ability were highly impaired. Slight con-structional apraxia was found, those aphasia, agraphia and alexia were not found. Neurological examination revealed bilateral superior hemianopia without visual agnosia, very slight left hemiparesis and left hemisensory impairment.
Computed tomography demonstrated low density area in the bilateral lower medial parts of occipital lobes. A right vertebral angiogram showed occlusion of the right vertebral artery at the level of C3 and thyrocervical-vertebral anastomosis. A left vertebral angi-ogram was normal.
Spatial disorientation is a rare symptom and seems to be related to infarcts of the bilateral lower medial parts of occipital lobe.
