Albert's test: a neglected test of perceptual neglect

Disorders of perception are thought to be important in predicting the outcome from stroke, but their exact significance is difficult to define because of lack of standardised terminology and diagnostic methods. In a prospective study of 205 unselected stroke patients, perceptual neglect, assessed by a standardised test battery, was found in 49% of patients with lesions of the non-dominant hemisphere and in 25% with lesions of the dominant hemisphere. One component of the test battery was a simple test described by Albert in which patients cross out lines ruled in a standard fashion on a sheet of paper; this was easy to administer and related closely to neglect diagnosed by the test battery as a whole. Results of Albert's test were a significant predictor of both mortality and functional activity six months after the stroke, independent of the influence of other clinical, neurological, laboratory, and social factors. The full test battery for perceptual neglect was of no significant additional predictive value.