Re: Left Side neglect after stroke

Posted By Charles Puckett on February 05, 1998 at 18:58:21:

In Reply to: Re: Left Side neglect after stroke posted by CCF Neuro MD *!* on December 28, 1997 at 16:17:26:







: : On 10/10 of this year, my wife (47 yrs old) suffered a deep vein hemmoragic stroke located above her right ear which affected both the frontal lobe and parietal lobe. She was transferred to the Hershey Medical Center's Rehab hospital about 11/16. Suprising everyone, she has responded to rehab well.  They initially thought she'd not be much more than an intelligent veggie but she's just blossomed. She walks, talks, eats by herself and in general is well on the way to recovery. I'm told her mental recovery is progressing well and there's no reason to expect anything less than an alomst full recovery in this area. She's blind in her right eye since birth and the stroke affected her left eye. She was partially paralized on the left side but this is responding very well. She suffers from left side neglect. The Eye department evaluated her remaining vision and told her she has lost a full 50% of the vision she has left and that she'll never be able to drive again. I've been told that this will never get any better and I've also been told that it may improve!!
My question is this: Can this left side neglect improve in some cases or is improvement generally not seen??   Thank You



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As you seem to have discovered already this is a difficult area in which to
make individual predictions from general principles, especially since your
wife is quite young to have had a stroke and generally younger age correlates
with a better than average recovery.
If your wife had a stroke in the right parietal area she would lose the
left half of the visual field from both eyes. Since she was operating on
only one eye prior to the stroke her visual field has been cut down to
a quarter of normal, namely the right half of the visual field in the
left eye, leaving no peripheral vision - a vital skill for driving.
Recovery in this situation may be expected to fall within the general
principles of recovery for any stroke, 80% of the recovery will occur
within the first 3 months and can be expected to continue up to six
months after the event, in some cases very small increments of improvement
may be noted after six months.
Given the situation now 2 1/2 months after the event you can anticipate
that most of the dramatic improvements have occurred but that slower
improvent can be anticipated for the next 3-4 months.
Obviously these are only general rules and recovery varies dramatically
from case to case, the likelehood of her driving again seems remote however.
I hope she does better than the odds and proves me wrong !