Neurologists have been caring for an elderly man who sustained a nondominant hemisphere stroke that caused left-sided hemiparesis and sensory loss. He has been uncooperative with hospital routine and insisting on discharge to his apartment. When they show him an American flag, he reports seeing only striped lines.
Even when the neurologists ask him to look all around and fully examine the fabric, the man maintains it is only striped cloth and probably part of a prisoner’s striped shirt. Which is the most likely explanation of his misperception?
Even when the neurologists ask him to look all around and fully examine the fabric, the man maintains it is only striped cloth and probably part of a prisoner’s striped shirt. Which is the most likely explanation of his misperception?
- He has a left homonymous hemianopsia.
- He has left-sided neglect or hemi-inattention.
- He has left/right confusion.
- He has dementia.
Although he may have left homonymous hemianopsia, his problem extends beyond simply a lack of vision on his left side. Someone with a left homonymous hemianopsia, especially when asked to look all around and fully examine something, would notice all its elements. He would have brought the star-filled rectangle into his right visual field. Instead, he neglected or remained inattentive to it.
Moreover, misinterpreting the flag as a prisoner’s shirt probably represents a reworking of his feelings of being kept against his will in the hospital.
Moreover, misinterpreting the flag as a prisoner’s shirt probably represents a reworking of his feelings of being kept against his will in the hospital.
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