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Neurological rarities
Mesial bifrontal stroke presenting as isolated spontaneous confabulations
  1. Vardan Nersesjan1,
  2. Henrik Gutte Bogwardt2,
  3. Daniel Kondziella1,3
  1. 1Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
  2. 2Department of Diagnostic and Neurointerventional Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
  3. 3Department of Clinical Medicine, Faculty of Health and Medical sciences, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Vardan Nersesjan, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen DK-2100, Denmark; vardan.nersesjan{at}gmail.com

Abstract

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.

  • FRONTAL LOBE
  • CONSCIOUSNESS
  • CLINICAL NEUROLOGY
  • CEREBROVASCULAR DISEASE

https://doi.org/10.1136/practneurol-2020-002518

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    Footnotes

    • Contributors VN is the main author of the manuscript. HGB has revised for intellectual content. DK has conceptualized the idea of the manuscript and revised for intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Consent obtained directly from patient(s).

    • Provenance and peer review Not commissioned; externally peer reviewed by Rose Bosnell, Gloucester, UK.