Right spatial neglect after left hemisphere stroke: qualitative and quantitative study

Neurology. 2004 Nov 9;63(9):1600-5. doi: 10.1212/01.wnl.0000142967.60579.32.

Abstract

Objectives: Comparatively little research has been conducted on right neglect after left brain damage. The authors sought to assess contralateral neglect in subacute left hemisphere stroke patients using a comprehensive test battery validated in a large control group after right hemisphere stroke.

Methods: Seventy-eight left hemisphere stroke patients were assessed. The test battery included a preliminary assessment of anosognosia and visual extinction, a clinical assessment of gaze orientation and personal neglect, and paper-and-pencil tests of spatial neglect in the peripersonal space. Only nonverbal tests were used.

Results: Drawing and cancellation tasks revealed neglect in 10 to 13% of patients. The combined battery was more sensitive than any single test alone. A total of 43.5% of patients showed some degree of neglect on at least one measure. Anatomic analyses showed that neglect was more common and severe when the posterior association cortex was damaged.

Conclusions: The frequency of occurrence of right neglect was, as expected, much lower than that reported in a study using the same assessment battery in right brain damage stroke patients. Nevertheless, neglect was found in a substantial proportion of patients at a subacute stage, suggesting that it should be considered in the rehabilitation planning of left brain damage stroke patients.

MeSH terms

  • Awareness
  • Cerebral Cortex / pathology
  • Female
  • Hemianopsia / diagnosis
  • Hemiplegia / diagnosis
  • Humans
  • Male
  • Middle Aged
  • Motor Skills
  • Stroke / diagnosis*
  • Stroke / pathology