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Subcortical neglect

E B Healton, C Navarro, S Bressman

    Neurology
    |July 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Unilateral neglect, typically from right cortex damage, can also result from deep brain lesions. This study presents the first autopsy-confirmed case of neglect solely due to striatum and white matter infarction.

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    Area of Science:

    • Neurology
    • Neuroscience
    • Neuroanatomy

    Background:

    • Unilateral neglect is a common neurological deficit usually associated with right cerebral cortex lesions, particularly the parietal lobe.
    • Subcortical lesions causing neglect are rare, with previous reports implicating thalamic or striatal hemorrhage/infarction, often with potential overlying cortical or white matter involvement.

    Observation:

    • This report details a unique case of sensory hemineglect, asomatognosia, and anosognosia.
    • The patient's symptoms were caused by an infarction affecting the striatum and deep white matter.
    • Crucially, there was no involvement of the cerebral cortex or thalamus, and no mass effect was present.

    Findings:

    • This is the first autopsy-confirmed instance of human neglect resulting exclusively from striatal and deep white matter infarction.

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  • The findings challenge the traditional view that cortical lesions are essential for neglect.

    • Implications:

    • This case expands our understanding of the neuroanatomical substrates of unilateral neglect.
    • It suggests that subcortical structures, specifically the striatum and associated white matter, play a critical role in spatial awareness and attention.
    • Further research into subcortical neglect mechanisms may reveal new therapeutic targets.