The anatomy of unilateral neglect after right-hemisphere stroke lesions. A clinical/CT-scan correlation study in man.

The anatomical correlates of extrapersonal visual neglect were investigated in 110 right-handed stroke patients with lesions confined to the right hemisphere. Neglect is much more frequently associated with retrorolandic damage, as compared with frontal lesions. The inferior parietal lobule appears to be the area most frequently involved in patients with cortical lesions showing signs of neglect. When the cerebral lesion is confined to deep structures, neglect occurs much more frequently when grey nuclei such as the thalamus and the basal ganglia are damaged; a remarkable number of negative cases were, however, found. Conversely, lesions limited to the subcortical white matter are rarely associated with neglect. The relevance of these results to anatomophysiological models of directed attention and neglect is discussed.