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A 76-year-old male patient was admitted to our hospital for the treatment of acute cerebral infarction in the right temporal stem, right lateral thalamus, and right pulvinar regions. Although his overall cognitive function was almost normal, he exhibited reduced visual sensitivity in the homonymous lower left quadrant of the visual field, left unilateral spatial neglect (USN), and simultanagnosia. Left USN improved 4 months after the onset of infarction; however, simultanagnosia persisted. To the best of our knowledge, this is the first case of simultanagnosia caused by cerebral infarction in the right temporal stem, right lateral thalamus, and right pulvinar regions.

Treatment to prevent progressive neurological deficits in acute penetrating artery infarction (API) is clinically important, but has not yet been established. This study aims to investigate the efficacy and safety of argatroban, aspirin, and clopidogrel combination therapy for API. Patients with API (lacunar infarcts or branch atheromatous disease) admitted within 48 hours after onset were enrolled. We assigned them to argatroban, aspirin, and clopidogrel (AAC) group or argatroban and aspirin (AA) group. In both groups, blood pressure was controlled to near or below 180/105 mmHg in the admission period. We defined progressing stroke as a worsening of two or more points in the National Institutes of Health Stroke Scale score on the seventh day of admission. Fifty-four patients were enrolled. We assigned 28 patients to the AAC group, and 26 patients to the AA group. There were no significant differences in background factors between the two groups. The incidence of progressing stroke was significantly higher in the AA group (P<0.05). Intracranial hemorrhage or any other bleeding was not seen in the admission period in either group. Our findings suggest that the AAC combination therapy may positively affect progressive neurological deficits in API patients.

Posture abnormality and gait impairments characterize of Parkinson's disease (PD), predict the risk of falling, and are important contributors to reduced quality of life. The quantitative measures of posture and gait may eventually provide usefulness as a biomarker in PD. This study included that 40 patients with PD (male 26, female 14, average age 70.4 ± 7.6 years old) and 17 normal healthy controls. We selected the quantified measures of the gait function, such as MDS-UPDRS, Timed up & go test, 5 feet walk test, 6 minutes-walk test. The posture angle of both forward flexion and lateral flexion were measured using the application of smartphone, which is capable even in a consulting room. The new posture quantitative measurement is stabile between examiners. The gait functions and the posture angles were significantly abnormal in the PD patients, compared to healthy controls (P < 0.001). The forward flexion angles were well correlated with the ages, on the other hand the lateral flexion angles were well correlated with the duration of the disease. The posture angles do not positively correlate with freezing gait but do correlate in limited univariate analyses with measures of gait function.