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Subcortical neglect

Departments of Neurology (Drs. Healton, Bressman, and Brust) and Pathology (Dr. Navarro), Harlem Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY.

Unilateral neglect is usually caused by lesions of the right cerebral cortex, especially parietal. Neglect after subcortical lesions has been reported rarely in thalamic or striatal hemorrhage, and after infarction of thalamus or striatum and internal capsule shown by CT. In these patients, there may have been compression or ischemia of overlying cerebral cortex and white matter. We report a patient with sensory hemineglect, asomatognosia, and anosognosia caused by infarction of striatum and deep white matter, with involvement of neither cortex nor thalamus and without mass effect. This is the first autopsy confirmed example of human neglect with involvement of only the striatum and deep white matter.

Address correspondence and reprint requests to Dr. Healton, Department of Neurology, Harlem Hospital Center, 506 Lenox Avenue, New York, NY 10037.

Presented in part at the thirty-third annual meeting of the American Academy of Neurology, Toronto, Canada, April 30, 1981.

Accepted for publication November 23, 1981.

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