case_images: PMC5465795_01
case_images: Standard Language Test of Aphasia (SLTA). The scores on day 47 were low for sentence repetition and word fluency in II (speaking) and all items of IV (writing). On day 225, sentence repetition and word fluency in II (speaking) remained unchanged. Moreover, kana-related items in IV (writing) improved, whereas scores for kanji-related items remained low.
case_images: crn-0009-0036-g01.jpg
case_images: PMC5465795_01_crn-0009-0036-g01.jpg
case_images: f1
case_images: Test of Aphasia (SLTA), the patient's scores were low for sentence repetition and word fluency in II (speaking) and all subcategories of IV (writing). The scores for written kanji words, narrative writing, and dictated kanji words were particularly low (Fig. 1, Fig. 2). In the SLTA, the sentence repetition and word fluency scores in II (speaking) remained unchanged; the IV (writing) scores tended to improve for kana-related items, but those for kanji-related items did not improve (Fig. 1).
case_images: a Brain magnetic resonance images (fluid-attenuated inversion recovery) on day 329. Slightly high signal intensities are to be seen in the periventricular white matter, centrum semiovale, subcortical white matter of the left supramarginal gyrus, and corpus callosum, in addition to mild but global atrophy of the brain. b99mTc-ethyl cysteinate dimer-single-photon emission computed tomography on day 329 (Z score map). Reduced blood flow was observed in the bilateral parietal lobes.
case_images: crn-0009-0036-g03.jpg
case_images: PMC5465795_01_crn-0009-0036-g03.jpg
case_images: f3
case_images: On day 329 of the illness, brain magnetic resonance imaging indicated slightly high signal intensities in the periventricular white matter, centrum semiovale, subcortical white matter of the left supramarginal gyrus, and corpus callosum in addition to mild but global atrophy of the brain on axial fluid-attenuated inversion recovery imaging (Fig. 3a). Brain perfusion scintigraphy using single-photon emission computed tomography (SPECT) revealed a decreased blood flow in the bilateral parietal lobes (Fig. 3b).