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(Stroke. 1999;30:946-948.)
© 1999 American Heart Association, Inc.

Original Contributions

Neglect After Right Insular Cortex Infarction

Presented in part at the 50th Annual Meeting Program of the American Academy of Neurology, Minneapolis, Minn, April 1998.

F. Manes, MD; S. Paradiso, MD; J. A. Springer, PhD; G. Lamberty, PhD R. G. Robinson, MD

From the Department of Psychiatry, University of Iowa College of Medicine, Iowa City, Iowa.

Background and Purpose—Case reports have shown an association between right insular damage and neglect. The aim of this study was to examine the incidence of neglect among patient groups with right or left insular infarction.

Methods—We examined neglect in 9 right-handed subjects with insular stroke as evidenced by CT and/or MRI scans (4 with right insular and 5 with left insular cerebrovascular accident) between 4 and 8 weeks after acute stroke with tests of visual, tactile, and auditory perception.

Results—Compared with patients with left insular lesions, patients with right insular lesions showed significant neglect in the tactile, auditory, and visual modalities.

Conclusions—The right insular cortex seems to have a role in awareness of external stimuli, and infarction in this area may lead to neglect in multisensory modalities.

Key Words: cerebral cortex • cerebral infarction • hemineglect • insula

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