Bagus Ngurah Mahasena Putera Awatara
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COGNITIVE FUNCTION ASPECTS IN HIV-ASSOCIATED CEREBRAL TOXOPLASMOSIS: A CASE REPORT Lasta Arshinta; Anak Agung Ayu Putri Laksmidewi; Ni Wayan Nurlina Ekasari; Dian Kusumastuti Anggraeni Putri; Gede Suputra; Bagus Ngurah Mahasena Putera Awatara
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.18

Abstract

HIV-associated cerebral toxoplasmosis may lead to cognitive function impairment through accumulation of β-amyloid plaques and Tau protein which cause damage, inflammatory and oxidative processes in the brain. A 40-year-old, Balinese, right-handed female patient, came with chief complaint of three times of seizure before admission. After the seizures stopped, the patient was fully conscious again. Since the last 2 months, the patient seemed more confused and spoke a little slower. The patient also often repeated a story about something and forgot that she had already told it. The patient has a known history of HIV infection in the past 3 months before admission, she had taken anti-retroviral agents but she stopped them by herself since last 1 month. Anti-Toxoplasma IgG antibody showed reactive results and CD-4 of 62 cells/µL. The results of the overall cognitive function examination found mild cognitive impairment with activities that required mild assistance. HIV-associated neurocognitive disorders (HAND) are still a challenge to study, and the importance of improving patient cognitive function to maintain or increase aspects of independence and quality of life is a target in the care of HIV patients, especially patients with HIV-associated cerebral toxoplasmosis infection.
A Rare Case of Anomic Aphasia and Gerstmann Syndrome Induced by Hemorrhagic Stroke Mahendrakrisna, Daniel; Bagus Ngurah Mahasena Putera Awatara; Gede Suputra; Ni Wayan Nurlina Ekasari; Dian Kusumastuti Anggraeni Putri; Anak Agung Ayu Putri Laksmidewi
Magna Neurologica Vol. 3 No. 2 (2025): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i2.2262

Abstract

Background: Aphasia is a language disorder caused by brain damage, such as a stroke. Anomic aphasia, a rare subtype, impairs the ability to name objects or people while preserving fluency and comprehension. It is often associated with Gerstmann syndrome, which is characterized by acalculia, finger agnosia, left-right disorientation, and semantic aphasia. This report presents a case of a 61-year-old male with anomic aphasia and Gerstmann syndrome following a hemorrhagic stroke. Case: A 61-year-old male patient presented with sudden difficulty recalling the names of family members and objects. Imaging revealed an intracerebral hemorrhage in the left parietotemporooccipital lobe. The patient also exhibited left-right disorientation and finger agnosia, indicative of Gerstmann syndrome. The Aphasia Test for Rehabilitation Information Diagnosis (TADIR) confirmed the diagnosis of anomic aphasia. Although conservative treatment led to partial improvement, naming difficulties and associated deficits persisted. Discussion: Anomic aphasia primarily involves difficulties with naming, typically resulting from lesions in the dominant hemisphere, particularly the temporal and parietal lobes. Its coexistence with Gerstmann syndrome underscores the complexity of overlapping neurological deficits. The TADIR test was crucial in diagnosing and managing the patient's condition. Conclusion: This case highlights the importance of a thorough evaluation in aphasia cases, especially when rare syndromes like Gerstmann syndrome are involved. Early and accurate diagnosis enables targeted interventions that can improve patient outcomes.