NeuroDash

The stroke case library

subacute — tier 3

The left side of the world is missing — unilateral neglect

Patient71M, subacute phase
LesionMCA territory, moderate-severe
SeverityNIHSS 11
Days since onset8
Before the strokeRetired draughtsman, meticulous, lives with his daughter
Also on the chartType 2 diabetes; Cataract surgery to the left eye last year
PrecautionsLeft-sided collisions during any mobility practice; Keep items he needs on his right until scanning improves

Test yourself

Which neglect intervention earns the central place in his programme?

The teaching

Active scanning anchored to functional tasks is the best-supported neglect intervention — the evidence is limited, so say so (Bowen 2013) Verbal cueing fades the moment the voice stops; build the strategy into the task Measure neglect in everyday behaviour with the Catherine Bergego Scale (Azouvi 2003)

Read next

The full sequence

This page carries the case’s first decision. The full sequence — every decision, the five-domain examination, and the debrief that grades you — is in the drill, and the library is included with membership.

Sources on this page: Bowen 2013, Cochrane Database of Systematic Reviews, cognitive rehabilitation for spatial neglect following stroke. Winstein 2016, Stroke, guideline for adult stroke rehabilitation and recovery · Azouvi 2003, Archives of Physical Medicine and Rehabilitation, the Catherine Bergego Scale for unilateral neglect. Bowen 2013, Cochrane Database of Systematic Reviews, cognitive rehabilitation for spatial neglect following stroke