Eight cases of the right unilateral spatial neglect (USN) caused by strokes with left brain damage, were reported and other neuropsychological findings and their effect on activities of daily living (ADL) were studied. Four cases were left-handed or had a familial disposition for left-handedness. The other four cases were “pure” right-handed. Two patients who had been forced into right handedness did not have aphasia, but they had right permanent USN. Although six patients who were naturally left-handed and right-handed had severe aphasia, right USN disappeared in several months, and ADL could be resumed.
It was shown from X-ray CT and MRI findings that left parieto-occipital lesion caused right USN. SPECT demonstrated a wider hypoperfusional lesion than that shown by X-ray CT and MRI.
These results suggest that right USN was caused by a similar lesion on the other hemishere, but different in process and severity due to the degree of lateralization on higher cortical function.

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We implanted diaphragm pacer (DP) in 15 apneic quadriplegic patients with brain stem or high cervical cord injury. Full time ventilatory support by DP was accomplished in 11 patients. At least half-time support was achieved in 2 others. Despite the loss of patients due to unrelated problems, 7 now still use DP continuously, one having done so for 18 years.
The most important factor in this successfull application of DP was patient selection, based on the results of a phrenic nerve conduction study to confirm the viability of phrenic nerve. We recommend a monopolar electrode and the cervical approach for electrode plancement. However, in small children, the thoracic approach is preferred.

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The relationship between the age-at-onset of aphasia and relevant clinical variables (i. e., concomitant impairment of nonlinguistic congnitive abilities, type of aphasia, lesion localization, type of cerebrovascular disease and years of education) was investigated in 90 aphasic patients and 72 age and education matched controls. All the subjects were right handed and had at least 6 years of education. All the aphasic patients had unilateral left-hemisphere lesions caused by cerebrovascular disease.
When the performance levels on 4 nonlinguistic cognitive tests developed by Benton were compared between the two groups, the decrease became more prominent for aphasic patients in older age groups compared to age and education matched controls. When the aphasic group was divided into two subgroups by age-at-onset (younger than 59 years and older than 60 years), type of aphasia and lesion localization revealed age-related differences between the two subgroups. A multivariate analysis revealed that aphasia type and lesion localization had high loadings on the severity of aphasia followed by the impairment of nonlinguistic cognitive abilities and age.

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