"R-side (cortex)" covers a LOTT of territory. If indeed cortical, this
narrows it down somewhat (e.g. not "pure motor stroke" due to some very
restricted subcortical sites), but big distinctions have to be made
between anterior and posterior--for example, unilateral neglect more
likely (or more likely to persist) after posterior lesions.
I've presented a few papers on some aspects of neglect. As regards
therapy: few have tried as hard as those at Rusk Institute, and their
own follow-up studies suggest it has little impact on long-term
problems with neglect in everyday life.
Within posterior cortex, dorsal vs. ventral distinctions are important:
the dorsal "visual stream" is more relevant to spatial relations (the
"where" system) and the ventral stream more relevant to object identity
(the "what" system). (I presented a paper at the International
Neuropsychological Society meeting in Seattle a few years ago, on a
test I developed to measure "what" and "where" visual memory separately
but concurrently; others have been following up on this--e.g. with
temporal lobe epilepsy patients).
SOMETIMES right hemisphere lesions can produce anosognosia. SOMETIMES
verbal discourse becomes poorly organized, redundant, etc., although
grammatically and semantically correct. SOMETIMES impaired social
perception is found.
Bottom line: don't assume you'll have ALL the symptoms which have been
reported (cf. "laundry list" of side effects in PDR), but do be on
alert for changes in behavior or ability--and do not ignore
observations by others of things you have not been aware of.
Unfortunately, few people take the precaution of having a thorough
neuropsych exam BEFORE their strokes or head traumas, so we always have
a hard time saying whether a given ability has been affected, or by how
much; however, such an exam after the injury can keep it in
perspective, i.e. how do you compare with others of your age, sex, and
educational background? how significant are any deficits (even if
detectable) to practical problems of employment, etc.
Some of your fellow COTAs may have books/web sites to consult,
expecially if they work in a rehab setting with neurological patients.
(My reading is chiefly in current literature--i.e. scientific
journals--and rarely in books, so I am always at a loss for this sort
of recommendation)
F. Frank LeFever, Ph.D.
New York Neuuropsychology Group
In <7mn9f2$itr$1 at grandprime.binc.net> " Kestrel" <adamr at mailbag.com>
writes:
>>Hi I'm 33 and had a R-side (cortex) hemorragic stroke in Nov of 98.
>>Though, my injury was considered severe, besides some residual motor
>disfunction to my L-side, I concider myself G-damn lucky.
>>My question(?) is this, does anyone know where I can be directed to
info on
>perception specific to this type of injury?
>>I don't know if perception is the proper term, at times, when I think
I'm
>"completely" focused on a task.I'll use the example of a game of darts
>(could be any cognitive related task...) sometimes I catch myself
misjudging
>things (scores,turns,strategy) and it can be VERY unnerving, because I
think
>it could be a cognitive impairment (though my WAIS scores indicated
good
>verbal skills, I did demonstrate some slight spatial deficits,though I
never
>considered this one of my strong suits to begin w/).
>>- I no longer see a neuropsychologist, and I'm not sure if I just need
to
>lighten up on myself and not make too much of these inconsequential
events,
>these occurances have never caused any accidents or impaired
>work/relationships, I'm just trying to further educate myself, and
determine
>if I may need to seek further professional assistance. I have a
background
>as a COTA w/ an interest in spatial perception (the sick irony..) any
>suggestions on web sites/books where I can educate myself and
train(rehab)
>my mind specific to spatial perception/judgement?
>>Thank You,
>>Adam
>>
