LETTERS Patient With Globus Pallidus Infarction Presenting With

To the Editor: A small single cerebral infarction can lead to dementia, which is known as “strategic infarct dementia. ” Cases of strategic infarct dementia caused by strokes located in the globus pallidus are extremely rare, although those caused by strokes located in the angular gyrus and thalamus have been often reported. Here, we report the case of a patient with a small infarct of the left globus pallidus who presented with reversible cognitive impairment without motor deficits or involuntary movement. Case Report A 57-year-old, right-handed woman was admitted to our hospital with complaints of behavioral distur-bance. The patient had been well until 1 day before admission, when she noted memory disturbance, mild disorientation, and word-finding difficulty. On admission, her level of consciousness was normal, and her Mini-Mental State Exam (MMSE) score was 24/30. There were no motor or sensory deficits. Neuro-psychological assessment revealed mild impairments in attention, ver-bal fluency, memory, and frontal function. On T2-weighted and diffusion-weighted MR images, a small, high-signal-intensity lesion was observed in the left basal gan-glia, mainly the left globus pallidus (Figure 1). A SPECT study showed a slight decrease in blood flow in the left basal ganglia without a decrease in the adjacent cortical blood flow. After admission, she was treated with anti-platelet agents, and her symptoms improved gradually. At FIGURE 1. MR Images Obtained on Admission T2-weighted (upper) and diffusion-weighted (lower) axial images show a small high-signal-intensity lesion in the left globus pallidus and a portion of the corona radiata