Predictors of functional outcome after right hemisphere stroke in patients with or without thrombolytic treatment

Losoi, Heidi; Kettunen, Jani E; Laihosalo, Mari; Ruuskanen, Eija-Inkeri; Dastidar, Prasun; Koivisto, Anna‐Maija; Jehkonen, Mervi

doi:10.1080/13554794.2011.608369

Cited by 4 publications

(1 citation statement)

References 33 publications

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“…U p to 80% of survivors of right brain stroke are not diagnosed with cognitive disorders of spatial cognition or awareness 1,2 during routine acute stroke care, and thus, they cannot receive a plan for personalized cognitive treatment. Worse, right brain stroke itself is underdiagnosed, so survivors of right brain stroke are at risk of undertreatment or incorrect treatment [3][4][5] because of the difficulty in identifying the cognitive hallmarks of right brain disorders during routine care.…”

Section: Introductionmentioning

confidence: 99%

Spatial Neglect and Anosognosia After Right Brain Stroke

Barrett¹

2021

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW Up to 80% of survivors of right brain stroke leave acute care without being diagnosed with a major invisible disability. Studies indicate that a generic cognitive neurologic evaluation does not reliably detect spatial neglect, nor does it identify unawareness of deficit after right brain stroke; this article reviews the symptoms, clinical presentation, and management of these two cognitive disorders occurring after right brain stroke. RECENT FINDINGS Stroke and occupational therapy practice guidelines stress a quality standard for spatial neglect assessment and treatment to reduce adverse outcomes for patients, their families, and society. Neurologists may attribute poor outcomes associated with spatial neglect to stroke severity. However, people with spatial neglect are half as likely to return to home and community, have one-third the community mobility, and require 3 times as much caregiver supervision compared with similar stroke survivors. Multiple randomized trials support a feasible first-line rehabilitation approach for spatial neglect: prism adaptation therapy; more than 20 studies reported that this treatment improves daily life independence. Evidence-based treatment of anosognosia is not as developed; however, treatment for this problem is also available. SUMMARY This article guides neurologists’ assessment of right brain cognitive disorders and describes how to efficiently assemble and direct a treatment team to address spatial neglect and unawareness of deficit.

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