Screening Tests for Visual Neglect Following Stroke

This study examined the incidence and implications of visual neglect in a group of elderly stroke patients. A consecutive series of 27 patients were assessed for visual neglect using four commonly administered tests at 15-20 days poststroke. Those who continued to show neglect were reassessed at 30,60, and 90 days. Incidence of visual neglect at 15-20 days poststroke was found to be 48%. A decrease in the number of patients with neglect occurred up to 90 days poststroke. Significant correlations between performance on the tests provided evidence for their construct validity. There was no significant evidence for laterality of neglect. The most sensitive measure for detecting visual neglect was found to be the Star Cancellation test, which was the best predictor of functional outcome as assessed by an Activities of Daily Living scale. Overall, the results indicated that the Star Cancellation test was the most effective and functionally useful measure of visual neglect. It is also suggested that rehabilitation procedures for moderately impaired patients take into account the spontaneous recovery of visual neglect symptoms.