Abstract
A 44-year-old man, who had a past history of diabetes mellitus, was admitted to our hospital suffering from apathy and hypobulia. On admission, neurological examinations revealed bradykinesia and lead pipe-like rigidity psychiatric manifestations such as impaired attention, loss of autonomy, and slurred speech were also observed. Examinations of higher brain functions disclosed amnesia and stereotypy. T 2-weighted MRI of the brain showed a high signal intensity in the bilateral thalamic regions, while a Gd-enhanced study demonstrated an enhancement of these regions. Cerebral angiography failed to reveal either the internal cerebral vein or the vein of Galen. The patient was therefore diagnosed as having deep cerebral vein thrombosis. We suggest that a disorder involving the connection between the thalamus and the frontal lobe may have played a role in his manifestations, because SPECT revealed a reduction in frontal lobe blood flow.
