Bilateral caudate nucleus infarction resulting from left ventricular diastolic dysfunction
Abstract Bilateral caudate infarct is a very rare neurological situation, usually caused by small-artery disease resulting from a cardiac embolism. The most prominent clinical features of caudate vascular lesions are behavioral and cognitive abnormalities. We report here a case of bilateral infarction of the caudate nucleus and right parietal lobe with loss of consciousness and left hemiparesia resulting from left ventricular diastolic dysfunction (LVDD). A 50-year-old woman was admitted to our clinic with symptoms of mental status change. One day ago before appearing at our clinic, the patient was hospitalized because of food intoxication and diarrhea. Her neurological examination revealed that orientation-cooperation was impaired, and motor weakness was found in the left extremities, predominantly in the upper limb. The lesions detected by CT and MRI were located on the bilateral caudate nucleus and right parietal lobe. Transthoracic echocardiography revealed LVDD. Therefore, the patient was diagnosed as having had an ischemic stroke. Three days after the treatment, all neurological deficits had improved and the patient was discharged. Attending physicians should be alert to the presence of permanent or intermittent complications of LVDD in patients with ischemic cerebral events, especially in patients with the bilateral caudate nucleus infarcts.