Gaze related enhancement of hemispheric blood flow in a stroke patient.

Nadeau, S E; Crosson, B; Schwartz, R L; Heilman, K M · J Neurol Neurosurg Psychiatry · 1997

case_report · Level V

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Abstract

A patient with a right posterior cerebral artery territory infarction and a left superior quadrantanopia exhibited improvement on various visual tasks including Goldmann perimetry during extreme right gaze. The phenomenon was investigated by functional imaging of cerebral blood flow. [(99m)Tc]HMPAO SPECT was carried out while the patient gazed to the right and to the left at an 8 Hz flash stimulus. When compared with left gaze, photic stimulation during right gaze was associated with an up to 39.8% increase in regional cerebral blood flow in the damaged right hemisphere, including Brodmann's areas 3-1-2, 7, 21, 22, 39, and 40. These gaze related alterations in function and synaptic activity suggest the engagement of a novel arousal-like mechanism that may account in part for comparable findings in patients with neglect and other disorders, and may have relevance to rehabilitation.

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