Mesial bifrontal stroke presenting as isolated spontaneous confabulations

A 52-year-old man with paroxysmal atrial fibrillation presented with spontaneous confabulation, working memory deficits, and frontal release signs. MR scan of brain showed bifrontal mesial ischaemic strokes and angiography demonstrated that both anterior cerebral arteries were supplied by the left i...

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Published inPractical neurology Vol. 20; no. 5; pp. 420 - 422
Main Authors Nersesjan, Vardan, Bogwardt, Henrik Gutte, Kondziella, Daniel
Format Journal Article
LanguageEnglish
Published London BMJ Publishing Group LTD 01.10.2020
Subjects
Carotid arteries
Medical imaging
Memory
Neurology
Patients
Sleep
Stroke
Veins & arteries
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Summary:A 52-year-old man with paroxysmal atrial fibrillation presented with spontaneous confabulation, working memory deficits, and frontal release signs. MR scan of brain showed bifrontal mesial ischaemic strokes and angiography demonstrated that both anterior cerebral arteries were supplied by the left internal carotid artery. Isolated spontaneous confabulation is a rare presentation of stroke and may be associated with orbitofrontal cortex lesions. Interestingly, functional imaging during rapid-eye-movement sleep may show bilateral medial frontal lobe hypometabolism, suggesting anatomical overlap between dreaming and the bizarre content of this patient’s spontaneous confabulation.
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ISSN:1474-7758
1474-7766
DOI:10.1136/practneurol-2020-002518