Patient 3A 5-year-old right-handed

Patient 3
A 5-year-old right-handed boy was admitted to rhe hospital because of vomiting, malaise, restlessness, and episodes of nocrurnal fecal and urinary incontinence that had started 15 days before. For five months the child had been less active, showing no interest in playing or drawing. He had increasing difficulty in dressing. Neurological examination revealed an alert bur easily farigable child. Language was unimpaired. Ocular fundi were normal. There was a slight left hemiparesis and a left facial hypalgesia. The left plantar response was extensor, and there was a moderate rruncal ataxia and left• side deviation when walking.
He presented a severe visuosparial disability: his perfor• mance on Benton's Visual Retention Test and his spontane• ous drawing of a human figure were poor. He demonsrrared left hemisparial neglect on cancellarion and line bisecrion casks (see Fig 1 ). His performance following simultaneous tactile stimulation was normal. On a task of repeated move• ments with both hands, the left hand tended gradually to stop. On a dichoric listening test he presented a left-channel exrincrion.
A CT scan revealed a very large hyperdense mass occupy• ing most of the right cranial cavity that enhanced homoge• neously wirh contrast. The mass had almost collapsed the right hemisphere and had produced marked midline shifr (Fig
4). Right cerebral arceriography showed a medial displace• ment of the sylvian arteries by a relatively vascular mass. The tumor, which proved to be a fibroblascic meningioma, was removed in rwo stages. Two days before the second opera• tion a bedside cancellation rest no longer showed evidence of neglect. Spontaneous drawing was still poor.
One month postoperatively muscle strength, sensory and visual field findings, and performance on cancellation and line bisection rests were normal. His performance on the Visual Retention Test was improved. He still presented a left• channel extinction on dichocic listening rests but no extinc• tion on simultaneous tactile or visual stimulation. The left hand no longer stopped moving in a cask requiring simultane• ous hand movements.

Hasil (Bahasa Indonesia) 2:

Pasien 3
Seorang anak kidal 5 tahun dirawat di rhe rumah sakit karena muntah, malaise, gelisah, dan episode nocrurnal inkontinensia tinja dan urin yang dimulai 15 hari sebelumnya. Selama lima bulan anak sudah kurang aktif, tidak menunjukkan minat dalam bermain atau menggambar. Dia telah meningkatkan kesulitan dalam berpakaian. Pemeriksaan neurologis mengungkapkan anak peringatan bur mudah farigable. Bahasa adalah utuh. Fundus mata normal. Ada hemiparesis kiri sedikit dan hypalgesia wajah kiri. Tanggapan plantar kiri adalah ekstensor, dan ada ataksia rruncal moderat dan kiri • deviasi sisi ketika berjalan.
Dia disajikan cacat visuosparial berat: nya perfor • Mance di Uji Retensi Visual Benton dan spontane • menggambar ous tentang sosok manusia yang miskin . Dia demonsrrared meninggalkan mengabaikan hemisparial pada cancellarion dan garis bisecrion tong (lihat Gambar 1). Penampilannya setelah stimulasi taktil simultan normal. Pada tugas berulang bergerak • KASIH dengan kedua tangan, tangan kiri cenderung secara bertahap untuk berhenti. Pada tes mendengarkan dichoric ia disajikan exrincrion kiri-channel.
CT scan mengungkapkan massa hyperdense sangat besar menempati • ing sebagian besar rongga tengkorak yang tepat yang ditingkatkan homoge • simultan wirh kontras. Massa sudah hampir ambruk belahan kanan dan telah menghasilkan ditandai garis tengah shifr (Gambar
4). Arceriography otak kanan menunjukkan medial menggusur • ment arteri Sylvian oleh massa yang relatif vaskular. Tumor, yang terbukti menjadi meningioma fibroblascic, telah dihapus secara bertahap rwo. Dua hari sebelum kedua opera • tion pembatalan sisa samping tempat tidur tidak lagi menunjukkan bukti kelalaian. Menggambar spontan masih miskin.
Satu bulan kekuatan otot pasca operasi, temuan lapangan sensorik dan visual, dan kinerja pada pembatalan dan garis pembelahan sisanya normal. Penampilannya di Retensi Uji Visual ditingkatkan. Dia masih disajikan • saluran kepunahan tersisa di bersandar mendengarkan dichocic tapi tidak ada extinc • tion pada taktil simultan atau rangsangan visual. Tangan kiri tidak lagi berhenti bergerak dalam tong yang membutuhkan gerakan tangan ous • simultan.