P2‐098: Isolated left posterior insular infarction with multiple cognitive impairment
Bibliographic record
Abstract
Insular involvement is commonly seen in the infarction of middle cerebral artery; however, the isolated left posterior insular infarction is markedly unusual. Apart from the disturbances related to the autonomic function and somatosensory perception, multiple cognitive domains can be affected by the lesion in this area. Present a case of isolated left posterior insular infarction resulting in language, verbal memory and fluency impairment. An 80 year old right-handed male with past medical history of diabetic mellitus and hypertension presented with acute onset of speech disarticulation and word-finding difficulty after waking up in the morning. The speech comprehension was still normal. He could not repeat complex sentences. He also had mild right-sided facial droop. Motor power and sensation of the body and extremities were intact. He was not eligible for the tissue plasminogen activator therapy due to unknown time of symptom onset. The head MRI demonstrated acute infarction at the left posterior insular cortex. MRA of the head and neck showed only hypoplastic A1 segment of the right anterior cerebral artery and 50 % stenosis of the right internal carotid artery which were not contributory to the acute infarction. 48 hours later, facial droop, disarticulation and word-finding difficulty completely improved. However, multiple domains of cognitive impairment were detected. He scored 20/30 on the Montreal Cognitive Assessment. He had significant impairment in delayed recall, letter & animal fluency and repetition tasks. The memory impairment characterized as retrieval deficit which improved with word cues. Naming was intact either in the MoCA or shortened version of Boston Naming Test.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".