- Jonathan J Stone: Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA. jjstone@buffalo.edu
BACKGROUND: Hemispatial neglect is classically associated with damage to the inferior parietal lobule of the right hemisphere, but is also infrequently linked with damage to the frontal lobe. A patient with contralateral hemispatial neglect after surgical resection of a right posterior inferior frontal lobe mass is described.
CASE DESCRIPTION: A 47-year-old right-hand dominant man presented after a focal motor seizure with secondary generalization. Magnetic resonance imaging (MRI) studies demonstrated a right inferior frontal lobe lesion, which was subsequently resected. Postoperatively, the patient was found to have a dense left-sided spatial hemineglect consisting of motor, sensory, and visual symptoms. During the ensuing week, the neglect resolved and the patient regained awareness of his left hemispace.
CONCLUSIONS: Although hemispatial neglect has been documented after stroke to the nondominant frontal lobe, to our knowledge this is the first report of transient hemispatial neglect after removal of a posterior inferior frontal lobe tumor. The neuroanatomic substrates underlying hemispatial neglect were investigated in an effort to explain our patient's clinical syndrome. In addition, the investigators suggest that special precautions and/or more detailed testing may be warranted intraoperatively when resecting inferior frontal lobe tumors.