Right Putaminal Hemorrhage and Unilateral Spatial Agnosia

Abstract

Unilateral spatial agnosia (USA) has been commonly seen in patients of right-sided hemispheric lesion. The incidence and duration of USA in cases of right subcortical lesions have been rarely reported. USA test, modified from Ohdoi's method, was given to 12 cases of right putaminal hemorrhage. USA was noted in 7 cases. Repeated examinations, starting from the acute stage, revealed a high incidence of USA. The symptom lasted for 3-4 weeks in mild cases (average antero-posterior CT diameter of lesions, 32mm), and for 3-4 months in severe cases (average diameter, 57mm). The USA continued for more than 10 months in a severely disabled case.
In comparison between cases with and without USA, the duration and incidence of USA were closely related to the degrees of neurological deficits (hemiparesis, sensory deficit, hemianopsia and conjugate eye deviation) and hematoma size on CT.
USA was commonly noted in cases of right putaminal hemorrhage as well as right cortical lesions. On beginning the rehabilitation in cases of such subcortical lesions, USA should always be kept in mind, as a possible higher cortical dysfunction, in order to make training-process effective and results more fruitful.