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Hemianopic anosognosia

G G Celesia1, M G Brigell, M S Vaphiades

  • 1Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, IL 60153, USA.

Neurology
|July 1, 1997
PubMed
Summary

Most patients with visual field loss from stroke are unaware of their deficit (hemianopic anosognosia). This unawareness is linked to lesion location and may indicate a distributed network for visual perception.

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Neurology

Background:

  • Homonymous visual field defects often result from ischemic infarcts.
  • Unawareness of neurological deficits, known as anosognosia, can occur in various neurological conditions.

Purpose of the Study:

  • To investigate the prevalence and characteristics of hemianopic anosognosia (HAN) in patients with homonymous visual field defects.
  • To explore the relationship between HAN, somatic anosognosia, and hemineglect.
  • To understand the neural correlates of conscious visual perception.

Main Methods:

  • Prospective study of 32 patients with homonymous visual field defects due to ischemic infarcts.
  • Assessment of hemianopic anosognosia, somatic anosognosia, and hemineglect.
  • Analysis of lesion locations and their association with awareness of visual deficits.

Main Results:

  • 62% of patients (20/32) exhibited hemianopic anosognosia (HAN).
  • HAN occurred in both right-sided (62%) and left-sided (67%) lesions.
  • HAN was associated with somatic anosognosia and hemineglect, but dissociation between these phenomena was observed.

Conclusions:

  • HAN is common in ischemic stroke causing visual field defects and is not strictly lateralized.
  • Conscious visual perception is not localized to a single cortical area but involves a distributed network.
  • Both hemispheres contribute to visual processing and awareness.

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