[Long-term prognosis of unilateral spatial neglect--dissociation between conventional tests and behavioral observation].

The long-term prognosis of unilateral spatial neglect (USN) in three elderly patients with stroke was investigated. Case 1 was a 62-year-old man who had suffered from right putaminal hemorrhage three years ago. Obvious right USN was found soon after the onset. After 6 months of rehabilitation he recovered and became independent in ADL without USN signs in daily circumstances. However, left USN signs appeared in some stressful situations such as traditional poetry-based competition or driving an electrical wheelchair on crowded roads. Case 2 was a 62-year-old man who had suffered from cerebral hemorrhage in the right putamen 6 years ago. He showed left USN soon after the onset, but it disappeared gradually. Cerebral infarction in the left basal ganglia occurred 6 years after the first attack. He showed decline of general attention accompanying left USN. Case 3 was a 70-year-old man who had showed left USN signs 7 years previously. He became independent and disappeared USN signs. However his activities of daily living declined gradually, and mental status became worse. Left USN signs were observed again on USN tests. Left USN was observed in three cases soon after the onset of the first stroke and then disappeared. However, USN signs became obvious in some specific situations. The appearance or disappearance of USN seemed to depend on the relationship among severity of USN, physical and mental functions, and circumstances in which USN was evaluated.