Frontal signs following subcortical infarction.

Abstract

Subcortical cerebral infarction is associated with impaired performance on tests of cognitive function which are sensitive to frontal lobe damage. In a cohort of 82 patients with multiple subcortical cerebral infarcts diagnosed on the basis of CT scan appearances, physical signs presumed to be sensitive to frontal lobe dysfunction were elicited. Associations between physical findings and CT scan changes were determined. The snout reflex was present in 38 patients and correlated significantly with the number of lesions, the presence of periventricular lucency and the presence of ventricular enlargement, while the grasp reflex occurred in 33 and correlated with the number of lesions and the presence of ventricular enlargement, and gait impairment in 54 correlated with the number of lesions and the presence of ventricular enlargement. It is assumed that multiple subcortical infarcts disrupt frontal association pathways, resulting in frontal disconnection which produces frontal cognitive dysfunction and frontal release signs.