Behavioral abnormalities after right hemisphere stroke

We evaluated 41 patients with unilateral right hemisphere strokes for hemiparesis, hemianopia, constructional apraxia, neglect, extinction, unilateral spatial neglect on drawing (USND), dressing apraxia, anosognosia, prosopagnosia, and motor impersistence. Low correlations were found among USND, neglect, and extinction. Constructional apraxia showed a higher correlation with USND than with hemianopia. Motor impersistence and anosognosia correlated with the severity of the hemiplegia. Left neglect, motor impersistence, and anosognosia tended to occur only with large strokes. Injury to the right parietal lobe appears to be an important determinant of USND and constructional apraxia. In most cases of motor impersistence, left neglect, and anosognosia, there was injury to the right parietal lobe and also to structures beyond the parietal lobe. In two cases, small deep lesions produced behavioral abnormalities comparable to those of larger superficial cortical lesions.