Utilization behavior refers to grasping and use of objects upon tactile or visual presentation. This report describes the clinical manifestations and course of utilization behavior after striatum and internal capsule infarction. The patient, a right-handed woman in her 40s, experienced an infarction in the right striatum and anterior limb of the internal capsule, followed by another infarction affecting the same regions on the left side 2 months later. Consistent with previously reported cases, her neuropsychological assessments revealed utilization behavior. Specifically, the patient sequentially picked up objects arranged on a table, stopping with brief restraint but quickly resuming the behavior. This utilization behavior persisted for approximately 4 months after the second stroke. Usually, symptoms of utilization behavior in cases involving unilateral striatum and internal capsule damage improve within approximately 2 months after onset. Thus, this patient's utilization behavior persisted for approximately 2 months longer than that reported in previous studies. This prolonged duration may be attributable to bilateral damage to the striatum and internal capsule due to the two consecutive strokes.

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