Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma

Kelechi Michael Azode; Ese-Enaorho Ewoye

doi:doi:10.11648/j.js.20251301.14

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Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma

Kelechi Michael Azode^*

, Ese-Enaorho Ewoye

Published in Journal of Surgery (Volume 13, Issue 1)

Received: 15 October 2024 Accepted: 4 November 2024 Published: 20 February 2025

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Abstract

Gerstmann syndrome, occasionally dubbed the angular gyrus syndrome is a constellation of clinical features that depict a potential inherent problem affecting the supramarginal and angular gyrus of the dominant left parietal cortex resulting in a partial or full complement of a tetrad of symptoms. It is a syndrome that depicts a derangement in key functions of the parietal lobe of the dominant hemisphere which is the left cerebral cortex in most people. Its cause can arise from a myriad of traumatic, vascular, tumoral, metabolic or infectious cerebral aetiologies. Chronic subdural hematoma is a common condition prevalent in the elderly population and managed by neurosurgeons worldwide. Its pathophysiology involves elaboration of fibrin degradation products, liquefaction of blood clots and new membrane formation due to fibroblast activity on a subdural hematoma over a period of time which warrants surgical treatment to ameliorate clinical features attributable to it. This article highlights the management of a relatively rare case in which features of Gerstmann syndrome were noted in a patient who had radiologic evidence of chronic subdural hematoma in the right non dominant hemisphere, bringing to the fore the importance of detailed neurologic evaluation of patients with parietal lobe lesions in either hemispheres for features of Gerstmann syndrome in order to avoid incidence of missed diagnosis which may influence holistic management of patients presenting symptom and reflect as suboptimal outcome following treatment.

Published in	Journal of Surgery (Volume 13, Issue 1)
DOI	10.11648/j.js.20251301.14
Page(s)	27-31
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Atypical, Presentation, Gerstmann Syndrome, Chronic Subdural

References

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[2]	Greenberg, M. Chronic subdural hematoma. Handbook of Neurosurgery. Thieme Medical Publishers. 2020; 10th Ed: 1081-86.
[3]	Greenberg, M. Chronic subdural hematoma. Handbook of Neurosurgery. Thieme Medical Publishers. 2020; 10th Ed: 98-99.
[4]	Altabakhi IW, Liang JW. Gerstmann Syndrome. 2023 Aug 28. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. PMID: 30137813.
[5]	Gerstmann J. Syndrome of finger agnosia, disorientation for right and left, agraphia and acalculia. Arch Neurol Psychiatry. 1940; 44: 398-407.
[6]	Geschwind N, Levitsky W. Human brain: left-right asymmetries in temporal speech region. Science. 1968; 161: 186-187.
[7]	Bear D, Schiff D, Saver J. Greenberg M, Freeman R. Quantitative analysis of cerebral asymmetries: fronto-occipital correlation, sexual dimorphism, and association with handedness. Arch Neurol. 1986; 43: 598-603.
[8]	Kertesz A, Black SE, Polk M, Howell J. Cerebral asymmetries on magnetic resonance imaging. Cortex. 1986; 22: 117-127.
[9]	Moore MR, Saver JL, Johnson KA, Romero JA. Right parietal stroke with Gerstmann’s syndrome. Appearance on computed tomography, magnetic resonance imaging, and single-photon emission computed tomography. Arch Neurol. 1991 Apr; 48(4): 432-5. https://doi.org/10.1001/arch
[10]	Maeshima S, Okumura Y, Nakai K, Itakura T, Komai N. Gerstmann’s syndrome associated with chronic subdural haematoma: a case report. Brain Inj. 1998 Aug; 12(8): 697-701.
[11]	Rusconi E, Pinel P, Dehaene S, Kleinschmidt A. The enigma of Gerstmann’s syndrome revisited: a telling tale of the vicissitudes of neuropsychology. Brain. 2010; 133(Pt 2): 320-332.
[12]	Nicastro N, Tafer N, Schnider A, Di Pietro M. Gerstmann’s Syndrome Associated with Right Parietal Hemorrhage and Arteriovenous Malformation. J Clin Neurol. 2017 Jul; 13(3): 306-307. https://doi.org/10.3988/jcn.2017.13.3.306 Epub 2017 May 15.
[13]	Varney NR. Gerstmann syndrome without aphasia: a longitudinal study. Brain Cogn. 1984; 3: 1-9.
[14]	Toader, C.; Covache-Busuioc, R.-A.; Rădoi, P. M.; Covlea, C.-A.; Popa, A. A.; Dumitrascu, D.-I.; Ciurea, A. V. Gerstmann Syndrome in an Elderly Patient: A Case Report Presented with a Complete Tetrad of Symptoms. Medicina 2024, 60, 1640. https://doi.org/10.3390/ medicina60101640
[15]	João, R. B.; Filgueiras, R. M.; Mussi, M. L.; de Barros, J. E. F. Transient Gerstmann syndrome as manifestation of stroke: Case report and brief literature review. Dement. Neuropsychol. 2017, 11, 202-205.
[16]	Bokka S, Trivedi A. Histopathological study of the outer membrane of the dura mater in chronic sub dural hematoma: Its clinical and radiological correlation. Asian J Neurosurg. 2016 Jan-Mar; 11(1): 34-8. https://doi.org/10.4103/1793-5482.154979

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APA Style

Azode, K. M., Ewoye, E. (2025). Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma. Journal of Surgery, 13(1), 27-31. https://doi.org/10.11648/j.js.20251301.14

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ACS Style

Azode, K. M.; Ewoye, E. Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma. J. Surg. 2025, 13(1), 27-31. doi: 10.11648/j.js.20251301.14

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AMA Style

Azode KM, Ewoye E. Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma. J Surg. 2025;13(1):27-31. doi: 10.11648/j.js.20251301.14

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@article{10.11648/j.js.20251301.14,
  author = {Kelechi Michael Azode and Ese-Enaorho Ewoye},
  title = {Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma
},
  journal = {Journal of Surgery},
  volume = {13},
  number = {1},
  pages = {27-31},
  doi = {10.11648/j.js.20251301.14},
  url = {https://doi.org/10.11648/j.js.20251301.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20251301.14},
  abstract = {Gerstmann syndrome, occasionally dubbed the angular gyrus syndrome is a constellation of clinical features that depict a potential inherent problem affecting the supramarginal and angular gyrus of the dominant left parietal cortex resulting in a partial or full complement of a tetrad of symptoms. It is a syndrome that depicts a derangement in key functions of the parietal lobe of the dominant hemisphere which is the left cerebral cortex in most people. Its cause can arise from a myriad of traumatic, vascular, tumoral, metabolic or infectious cerebral aetiologies. Chronic subdural hematoma is a common condition prevalent in the elderly population and managed by neurosurgeons worldwide. Its pathophysiology involves elaboration of fibrin degradation products, liquefaction of blood clots and new membrane formation due to fibroblast activity on a subdural hematoma over a period of time which warrants surgical treatment to ameliorate clinical features attributable to it. This article highlights the management of a relatively rare case in which features of Gerstmann syndrome were noted in a patient who had radiologic evidence of chronic subdural hematoma in the right non dominant hemisphere, bringing to the fore the importance of detailed neurologic evaluation of patients with parietal lobe lesions in either hemispheres for features of Gerstmann syndrome in order to avoid incidence of missed diagnosis which may influence holistic management of patients presenting symptom and reflect as suboptimal outcome following treatment.
},
 year = {2025}
}

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TY  - JOUR
T1  - Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma

AU  - Kelechi Michael Azode
AU  - Ese-Enaorho Ewoye
Y1  - 2025/02/20
PY  - 2025
N1  - https://doi.org/10.11648/j.js.20251301.14
DO  - 10.11648/j.js.20251301.14
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 27
EP  - 31
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20251301.14
AB  - Gerstmann syndrome, occasionally dubbed the angular gyrus syndrome is a constellation of clinical features that depict a potential inherent problem affecting the supramarginal and angular gyrus of the dominant left parietal cortex resulting in a partial or full complement of a tetrad of symptoms. It is a syndrome that depicts a derangement in key functions of the parietal lobe of the dominant hemisphere which is the left cerebral cortex in most people. Its cause can arise from a myriad of traumatic, vascular, tumoral, metabolic or infectious cerebral aetiologies. Chronic subdural hematoma is a common condition prevalent in the elderly population and managed by neurosurgeons worldwide. Its pathophysiology involves elaboration of fibrin degradation products, liquefaction of blood clots and new membrane formation due to fibroblast activity on a subdural hematoma over a period of time which warrants surgical treatment to ameliorate clinical features attributable to it. This article highlights the management of a relatively rare case in which features of Gerstmann syndrome were noted in a patient who had radiologic evidence of chronic subdural hematoma in the right non dominant hemisphere, bringing to the fore the importance of detailed neurologic evaluation of patients with parietal lobe lesions in either hemispheres for features of Gerstmann syndrome in order to avoid incidence of missed diagnosis which may influence holistic management of patients presenting symptom and reflect as suboptimal outcome following treatment.

VL  - 13
IS  - 1
ER  -

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Author Information

Kelechi Michael Azode

Neurosurgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

Contact Email

http://orcid.org/0000-0001-5198-4749
Ese-Enaorho Ewoye

Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

Contact Email

http://orcid.org/0000-0002-9383-3196

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Plain Text BibTeX RIS

APA Style

Azode, K. M., Ewoye, E. (2025). Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma. Journal of Surgery, 13(1), 27-31. https://doi.org/10.11648/j.js.20251301.14

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ACS Style

Azode, K. M.; Ewoye, E. Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma. J. Surg. 2025, 13(1), 27-31. doi: 10.11648/j.js.20251301.14

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AMA Style

Azode KM, Ewoye E. Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma. J Surg. 2025;13(1):27-31. doi: 10.11648/j.js.20251301.14

Copy | Download

@article{10.11648/j.js.20251301.14,
  author = {Kelechi Michael Azode and Ese-Enaorho Ewoye},
  title = {Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma
},
  journal = {Journal of Surgery},
  volume = {13},
  number = {1},
  pages = {27-31},
  doi = {10.11648/j.js.20251301.14},
  url = {https://doi.org/10.11648/j.js.20251301.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20251301.14},
  abstract = {Gerstmann syndrome, occasionally dubbed the angular gyrus syndrome is a constellation of clinical features that depict a potential inherent problem affecting the supramarginal and angular gyrus of the dominant left parietal cortex resulting in a partial or full complement of a tetrad of symptoms. It is a syndrome that depicts a derangement in key functions of the parietal lobe of the dominant hemisphere which is the left cerebral cortex in most people. Its cause can arise from a myriad of traumatic, vascular, tumoral, metabolic or infectious cerebral aetiologies. Chronic subdural hematoma is a common condition prevalent in the elderly population and managed by neurosurgeons worldwide. Its pathophysiology involves elaboration of fibrin degradation products, liquefaction of blood clots and new membrane formation due to fibroblast activity on a subdural hematoma over a period of time which warrants surgical treatment to ameliorate clinical features attributable to it. This article highlights the management of a relatively rare case in which features of Gerstmann syndrome were noted in a patient who had radiologic evidence of chronic subdural hematoma in the right non dominant hemisphere, bringing to the fore the importance of detailed neurologic evaluation of patients with parietal lobe lesions in either hemispheres for features of Gerstmann syndrome in order to avoid incidence of missed diagnosis which may influence holistic management of patients presenting symptom and reflect as suboptimal outcome following treatment.
},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Atypical Presentation of Gerstmann Syndrome in a Patient with Encapsulated Right Chronic Subdural Hematoma

AU  - Kelechi Michael Azode
AU  - Ese-Enaorho Ewoye
Y1  - 2025/02/20
PY  - 2025
N1  - https://doi.org/10.11648/j.js.20251301.14
DO  - 10.11648/j.js.20251301.14
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 27
EP  - 31
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20251301.14
AB  - Gerstmann syndrome, occasionally dubbed the angular gyrus syndrome is a constellation of clinical features that depict a potential inherent problem affecting the supramarginal and angular gyrus of the dominant left parietal cortex resulting in a partial or full complement of a tetrad of symptoms. It is a syndrome that depicts a derangement in key functions of the parietal lobe of the dominant hemisphere which is the left cerebral cortex in most people. Its cause can arise from a myriad of traumatic, vascular, tumoral, metabolic or infectious cerebral aetiologies. Chronic subdural hematoma is a common condition prevalent in the elderly population and managed by neurosurgeons worldwide. Its pathophysiology involves elaboration of fibrin degradation products, liquefaction of blood clots and new membrane formation due to fibroblast activity on a subdural hematoma over a period of time which warrants surgical treatment to ameliorate clinical features attributable to it. This article highlights the management of a relatively rare case in which features of Gerstmann syndrome were noted in a patient who had radiologic evidence of chronic subdural hematoma in the right non dominant hemisphere, bringing to the fore the importance of detailed neurologic evaluation of patients with parietal lobe lesions in either hemispheres for features of Gerstmann syndrome in order to avoid incidence of missed diagnosis which may influence holistic management of patients presenting symptom and reflect as suboptimal outcome following treatment.

VL  - 13
IS  - 1
ER  -

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