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Appearance on Computed Tomography, Magnetic Resonance Imaging, and Single-Photon Emission Computed Tomography

Matthew R. Moore, MD; Jeffrey L. Saver, MD; Keith A. Johnson, MD; Jorge A. Romero, MD

Arch Neurol. 1991;48(4):432-435.

Abstract
• We examined a patient who exhibited Gerstmann's syndrome (left-right disorientation, finger agnosia, dyscalculia, and dysgraphia) in association with a perioperative stroke in the right parietal lobe. This is the first description of the Gerstmann tetrad occurring in the setting of discrete right hemisphere pathologic findings. A well-localized vascular lesion was demonstrated by computed tomography, magnetic resonance imaging, and single-photon emission computed tomographic studies. The patient had clinical evidence of reversed functional cerebral dominance and radiologic evidence of reversed anatomic cerebral asymmetries.

Author Affiliations
From the Departments of Neurosurgery (Dr Moore) and Neurology (Drs Saver and Romero), Brigham and Women's Hospital, and the Department of Neurology (Dr Johnson), Massachusetts General Hospital and Harvard Medical School, Boston, Mass.

Footnotes
Accepted for publication October 3, 1990.

Reprint requests to Department of Neurosurgery, Children's Hospital Medical Center, 300 Longwood Ave, Boston, MA 02115 (Dr Moore).

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