Schutz Larry E
Rehabilitation Neuropsychology Associates of Orlando, Florida 32819, USA.
Neuropsychol Rev. 2005 Mar;15(1):11-27. doi: 10.1007/s11065-005-3585-5.
Traditional accounts of right-posterior brain injury describe a syndrome of low-level perceptual sequelae producing marked acute dependency and transient safety concerns. The syndrome is also held to spare cognition and to carry a generally favorable long-term prognosis. The present paper reviews publications and anecdotal data that challenge this picture. Recent theoretical expositions and empirical studies stipulate three major cognitive functions of the right posterior association cortex: processing novel input, guiding reactions to emergencies, and anticipating consequences. Appearing benign after acute recovery, the impairment of these processes produces vocational, social and marital dysfunctions that increase as a function of chronicity, ultimately becoming more broadly disabling than focal injuries in other cortical loci. The unique symptom picture and serious implications suggest that the long-term syndrome should be labeled (Broad-Perspective Perceptual Disorder) and incorporated in future clinical taxonomies, underscoring the need for extraordinary long-term assistance and specialized therapeutics. Procedures for assessment and differential diagnosis are outlined.
传统上对右后脑损伤的描述是一种低水平感知后遗症综合征，会导致明显的急性依赖和短暂的安全担忧。该综合征也被认为不会影响认知，且总体长期预后良好。本文回顾了对这一观点提出质疑的出版物和轶事数据。最近的理论阐述和实证研究规定了右后联合皮层的三大主要认知功能：处理新输入信息、指导对紧急情况的反应以及预测后果。这些过程的损伤在急性恢复后看似无害，但会导致职业、社交和婚姻功能障碍，并随着时间的推移而加剧，最终比其他皮层部位的局灶性损伤导致更广泛的功能丧失。独特的症状表现和严重后果表明，这种长期综合征应被命名为（广义感知障碍）并纳入未来的临床分类中，强调了长期特殊援助和专门治疗的必要性。文中还概述了评估和鉴别诊断的程序。
