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A case study of hemispatial neglect using finite element analysis and positron emission tomography

Lookup NU author(s): Peter Crawford

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Abstract

Background The authors present a patient who developed transient hemispatial neglect following surgical drainage of a large right frontotemporal arachnoid cyst. As symptoms evolved in parallel with brain shift over the subsequent months, the authors hypothesized that the disorder was associated with the appearance of mechanical stresses in the cerebral mantle. Methods To map tissue stress at the various stages of deformation, a finite element computer simulation was conducted on the basis of computed tomography scans of the patient Results. The authors' results demonstrate substantial shear and compressive stress concentrations in the parietal lobe, a region commonly associated with neglect, and where positron emission tomography confirmed hypoperfusion in this patient Treatment with combined ventricular-peritoneal and cystoperitoneal shunts was accompanied by clinical recovery and improvement of right parietal lobe cerebral blood flow Conclusions. The authors conclude that brain deformation was a contributing factor in the reversible neglect syndrome by compromising the normal flow of blood and/or the deactivation of subcortical circuits of the parietal lobe.

Publication metadata

Author(s): Pena A, Owler BK, Fryer TD, Minhas P, Czosnyka M, Crawford PJ, Pickard JD

Publication type: Article

Publication status: Published

Journal: Journal of Neuroimaging

Year: 2002

Volume: 12

Issue: 4

Pages: 360-367

ISSN (print): 1051-2284

ISSN (electronic): 1552-6569

Publisher: Wiley-Blackwell Publishing, Inc.

URL: http://dx.doi.org/10.1177/105122802237980

DOI: 10.1177/105122802237980

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