A 52-year-old man with paroxysmal atrial fibrillation presented with spontaneous confabulation, working memory deficits, and frontal release signs. MR scan of brain showed bifrontal mesial ischaemic strokes and angiography demonstrated that both anterior cerebral arteries were supplied by the left internal carotid artery. Isolated spontaneous confabulation is a rare presentation of stroke and may be associated with orbitofrontal cortex lesions. Interestingly, functional imaging during rapid-eye-movement sleep may show bilateral medial frontal lobe hypometabolism, suggesting anatomical overlap between dreaming and the bizarre content of this patient’s spontaneous confabulation.

中文翻译：

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内侧双额中风表现为孤立的自发性交谈

一名患有阵发性房颤的 52 岁男性因自发性胡言乱语、工作记忆缺陷和额叶释放体征就诊。脑部 MR 扫描显示双额内侧缺血性中风，血管造影显示两个大脑前动脉均由左侧颈内动脉供血。孤立的自发性胡言乱语是中风的一种罕见表现，可能与眶额皮质病变有关。有趣的是，快速眼动睡眠期间的功能成像可能会显示双侧内侧额叶代谢减退，这表明做梦与该患者自发虚构的奇怪内容之间存在解剖学重叠。