Association between the related characters of hemispatial neglect and prognosis in stroke patients

Yongcai Wang; Lianzhong Wang; Shiwen Liu

摘要：OBJECTIVE: To recognize the significances of the classification, evaluation, treatment, pathogenesis, etiological factors and related foci of hemispatial neglect (HSN) in the treatment and prognosis of stroke patients.DATA SOURCES: Articles related to HSN in stroke published in English from January 1985 to December 2002 were searched in Medline database by using the keywords of "stroke, hemispatial neglect (HSN), rehabilitation". Chinese relevant professional works and articles were also referred to.STUDY SELECTION: The data were primarily checked. Inclusive criteria: ① articles about the HSN symptoms in stroke; ② articles about the classification, evaluation, treatment, pathogenesis, etiological factors and related foci of HSN, as well as the treatment and prognosis of stroke. The repetitive studies or reviews were excluded.DATA EXTRACTION: Totally 474 articles related to HSN in stroke were collected, 43 of them were involved,and 431 repetitive studies or reviews were excluded.DATA SYNTHESIS: HSN can be classified as sensory neglect and motor neglect. Because HSN is caused by the injury of network structure which mediated directed attention, it is generally believed that the inferior parietal Iobule of dominant hemisphere is the most closely correlated with neglect. The main theories related to the pathogenesis of HSN at present include "internal instruction", "directed bradykinesia", "sensory attention", etc. The main clinical manifestations are setover in drawing lines, picture drawing towards one side, imitation towards one side, picture description towards one side, etc., which can be evaluated by the line bisection test, target cancellation test, picture drawing test and pegboard test. The most important thing for the treatment is to make the patients continuously concentrate on the neglected side.CONCLUSION: HSN is an indicator for the bad outcome of cerebrovascular disease, the symptoms take longer time to rehabilitate with slow recovery, but quite a few HSN patients will get good prognosis if timely treatment and proper program are given.