2000 Volume 37 Issue 8 Pages 508-516
The clinical course of unilateral spatial neglect (USN) were studied in 128 acute stroke patients who started rehabilitation within one week after onset. USN was evaluated by standard three tasks (cancellation test, line bisection test, copy test), which result was compared with the severity of patient's behavior disturlance and the findings of 123I-IMP-SPECT. The incidence of USN was 26.6% in 128 acute patients and the 29.4% of USN were disappeared within 3.4 weeks on the average. Total score of three tasks had a close relationship to abnormal behavior caused by USN, however each task such as line bisection test often underestimated its severity. In comparison between cases with and without disappearance of USN, the characteristic of disappeared cases were as follow; the degree of hemiparesis was mild, the cause of disability was cerebral infarction, and their age was lower. Additionally we investigated IMP-SPECT findings about the size of low perfusion area and its redistribution at the right tempro-parieto-occipital region in 22 patients with right-sided hmispheric lesion. The cases which had large low perfusion area with poor redistribution were remained to have severe USN. On the other hand, the cases with good redistribution had better prognosis about USN. To predict clinical course of USN is one of the most important point when we try to determine rehabilitation goal of stroke patients. Total score method of three tasks and IMP-SPECT findings can be good indication to get exact information about USN prognosis.
