Kashiwagi A, Kashiwagi T, Nishikawa T, Tanabe H, Okuda J
Kyoritsu Rehabilitation Hospital, Hyogo, Japan.
Brain. 1990 Aug;113 ( Pt 4):1005-23. doi: 10.1093/brain/113.4.1005.
Left hemispatial neglect, confined to right-hand and verbal responses, was exhibited by a 56-yr-old right-handed male patient with callosal lesions due to cerebral infarction. Various disconnection signs were also present. His CT and MRI scans disclosed major lesions situated in the posterior half of the genu and the whole trunk of the corpus callosum, as well as in the left medial frontal and temporo-occipital lobes. Left hemispatial neglect was invariably demonstrated in right-hand performance such as copying drawings, line bisection, matching identical figures and copying multiple digit numbers, and in verbal performance such as confrontation naming and reading aloud multiple digit numbers. In contrast, little or no right hemispatial neglect was demonstrated in tasks performed with the left hand. These findings support the hypothesis that the left hemisphere is only concerned with attending to the contralateral hemispace and that the right hemisphere is specialized for attending to both sides of space although the preponderant tendency is for attending to the contralateral hemispace. The neglect symptoms observed in our patient may be a disconnection sign which was attributable to a combination of lesions in the corpus callosum and in the left medial frontal lobe.
一名56岁的右利手男性患者因脑梗死导致胼胝体病变，出现了仅局限于右手和言语反应的左侧半空间忽视。同时还存在各种分离症状。他的CT和MRI扫描显示，主要病变位于胼胝体膝部后半部和整个胼胝体干，以及左侧额内侧叶和颞枕叶。在右手执行的任务中，如临摹图画、线段平分、匹配相同图形和抄写多位数字，以及言语任务中，如对物体命名和大声朗读多位数字时，总是会出现左侧半空间忽视。相比之下，用左手执行任务时，很少或几乎没有出现右侧半空间忽视。这些发现支持了以下假设：左半球仅关注对侧半空间，而右半球专门负责关注两侧空间，尽管主要倾向是关注对侧半空间。在我们的患者中观察到的忽视症状可能是一种分离症状，这是由于胼胝体和左侧额内侧叶的病变共同作用所致。
