نبذة مختصرة : Objective To describe neurobehavioral consequences and recovery course in a case of acute infarct of the fornix superimposed on chronic subcortical cerebrovascular disease. Method We present a right-handed, 72-year-old, African American man with cardiovascular risk factors, chronic kidney disease, and history of CVA with no prior functional or cognitive difficulties. He was evaluated twice, first four days post and again two months post-infarct of the bilateral fornix. Results Initial inpatient testing revealed impaired verbal memory characterized by rapid forgetting (HVLT-R Delay T = < 20) with some benefit from recognition cues, and subtle deficits in constructional praxis and practical judgement. On repeat evaluation at four months post-stroke, he demonstrated memory impairment across modalities (HVLT-R Delay T = < 20, BVMT-R Delay T = < 20) with marginal benefit from context and cues. He required assistance with multiple instrumental activities of daily living (e.g., financial and healthcare management) and displayed anosognosia of both cognitive and functional deficits. Conclusion This case illustrates the role of the fornix in the process of memory encoding and self-awareness. Literature describing the neurobehavioral role of the fornix is sparse, however, it has been implicated in episodic memory functions due to hippocampal connectivity. This case study further implicates the fornix in declarative memory formation and will add to the literature by detailing a specific cognitive profile that may inform planning for recovery and rehabilitation.
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