In recent years important additions to the knowledge of the symptomatology in cases with involvement of the parietal lobe have been made. Both constructional apraxia (Kleist, 1922) and Gerstmann's syndrome, consisting of finger-agnosia, disturbance of right-left orientation, agraphia and acalculia (1924) have been related to lesions of the angular gyrus of the dominant hemisphere. Before the description of those symptoms, a loss of spatial orientation had been described in cases with lesions of the same localization. Balint (1910), Riddoch (1917), and others had observed that symptom in single cases, but the most comprehensive description was given by Gordon Holmes (1918), who studied it in a case-material of war injuries. When Holmes and his co-workers published their observations, constructional apraxia and Gerstmann's syndrome were still unknown. Loss of spatial orientation as a fully developed symptom is rare, while the other two disorders are not uncommon. For this reason the psychopathological relationship of those symptoms is still insufficiently understood. The following case offers an opportunity for studying the problem:
The ‘Gerstmann's Syndrome’ of transjugular intrahepatic portosystemic shunt: should it be the left or should it be the right
