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Left neglect in addition to cortical blindness following gunshot wound to the right hemisphere
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Abstractsfiom the 17thAnnualMeeting
Reed, K. M., Robinson,K., Caroselli,J., & May,R. L@ Neglect in Addition to Cortical Blindness Following Gunshot Wound to the Right Hemisphere.
The connectionbetweenleft neglectand right hemisphereprocessingis well-documented. The phenomenaof left neglectin combinationwith blindnesshas receivedlittleattention.A left neglectis consideredby many to be independentof visionand this case study supports this assertion.A 32-year-oldwomanpost-injurypresentedwith a gunshotwoundinvolving the occipitaland right parietalregionresultingin corticalblindness.However,unlikeother individualswithblindnesswe treat, sheexhibiteddifilcultylearningsimplerouteseven with extensiverepetition.Clinicalstaff reportedthat she exhibited“excessivedependence”and “was not trying”when comparingher performanceto otherblindclientswith brain injuries at our facility.Resultsof evaluationshowedgoodverbalintelligencebut severeimpairment of topographicalorientationand spatialawareness,and a left neglect.Traditionalways of teachingindividualswithvisualimpairment,spatialroutessuchas tactilemapsandrepetition were completelyineffective,and she requireddetailed,short,verbal directionsto navigate any route alone.Her resultswill be discussedin referenceto a clientwith completecortical blindnesswithout neglect as well as a sighted client who presented with a left neglect. Successfuland unsuccessfulrehabilitationstrategieswill be presented. Sherer,M., Meyers,C., & Bergloff,P. Neuropsychological Rehabilitation of Patients with Primary Malignant Brain Tumors.
Primarymalignantbrain cancer is a devastatingillnesswith a very poor prognosis.Traditionally,brain tumor patients have not been referred for rehabilitationservices to help improvetheir independenceand abilityto work. This failureto refer for rehabilitationhas beencausedby thecommonassumptionthatpatientswithsuchbleaklongtermprognosisare poorcandidatesfor rehabilitationandby the lackof anyresearchevaluatingthe effectiveness of neuropsychologicalrehabilitationwith such patients.The presentpaper presentsthe first investigationof the efllcacyof postacutebraininjuryrehabilitationservicesfor patientswith primary malignantbrain cancer. Subjectswere 13 patients treated for primary malignant brain cancerand subsequentlyseen for outpatientbrain injuryrehabilitation.All 13 patients had surgeryand radiationand 12 also had chemotherapy.Therewere 8 malesand 5 females with a mean age of 34.3 + 10.0years and mean educationof 15.1 + 1.7 years.Mean time from tumor diagnosisto admissionfor treatmentwas 75.4 + 87.9 months.The treatment programfor these patientswas similarto approachesdevelopedfor traumaticbrain injury patients.At follow-upconductedan averageof 7.5 + 7.6 monthspostdischarge,as compared to admissionstatus,7 patientsshowedincreasedindependence,4 were unchanged,1 showed decreasedindependence,and 1 patienthad expired.Regardingproductivitystatusat followup, 9 patientsshowedincreasedproductivity,1 patientwas unchanged,2 patientsshowed decreasedproductivity,and 1 patienthad expired.Resultsshow that these patientsshowed improvementwith treatmentand these gainswere maintainedat follow-up. Tomaszewski,R. J., Lee, J., & Fratisch,N. Facilitating Effective Behavioral Intervention Within the Acute Rehabilitation Treatment Milieu.
Whilenumerousbehavioralinterventionshaveconceptualrelevanceto the problemsencounteredin AcuteRehabilitation(McGlynn,1990),the pragmatic of implementinga behavioral interventionwithin the Acute Rehabilitationtreatmentmilieu have not been specifically addressed.In the present study,the behavioralinterventionwas conceptualizedas taking place within the milieu (Prigatano& Schacter,1991)rather than simplyupon the patient. Thus,a behavioralcore groupof interestedteammembersparticipatedin behaviormeetings
Abstractsfiom the 17thAnnualMeeting
Reed, K. M., Robinson,K., Caroselli,J., & May,R. L@ Neglect in Addition to Cortical Blindness Following Gunshot Wound to the Right Hemisphere.
The connectionbetweenleft neglectand right hemisphereprocessingis well-documented. The phenomenaof left neglectin combinationwith blindnesshas receivedlittleattention.A left neglectis consideredby many to be independentof visionand this case study supports this assertion.A 32-year-oldwomanpost-injurypresentedwith a gunshotwoundinvolving the occipitaland right parietalregionresultingin corticalblindness.However,unlikeother individualswithblindnesswe treat, sheexhibiteddifilcultylearningsimplerouteseven with extensiverepetition.Clinicalstaff reportedthat she exhibited“excessivedependence”and “was not trying”when comparingher performanceto otherblindclientswith brain injuries at our facility.Resultsof evaluationshowedgoodverbalintelligencebut severeimpairment of topographicalorientationand spatialawareness,and a left neglect.Traditionalways of teachingindividualswithvisualimpairment,spatialroutessuchas tactilemapsandrepetition were completelyineffective,and she requireddetailed,short,verbal directionsto navigate any route alone.Her resultswill be discussedin referenceto a clientwith completecortical blindnesswithout neglect as well as a sighted client who presented with a left neglect. Successfuland unsuccessfulrehabilitationstrategieswill be presented. Sherer,M., Meyers,C., & Bergloff,P. Neuropsychological Rehabilitation of Patients with Primary Malignant Brain Tumors.
Primarymalignantbrain cancer is a devastatingillnesswith a very poor prognosis.Traditionally,brain tumor patients have not been referred for rehabilitationservices to help improvetheir independenceand abilityto work. This failureto refer for rehabilitationhas beencausedby thecommonassumptionthatpatientswithsuchbleaklongtermprognosisare poorcandidatesfor rehabilitationandby the lackof anyresearchevaluatingthe effectiveness of neuropsychologicalrehabilitationwith such patients.The presentpaper presentsthe first investigationof the efllcacyof postacutebraininjuryrehabilitationservicesfor patientswith primary malignantbrain cancer. Subjectswere 13 patients treated for primary malignant brain cancerand subsequentlyseen for outpatientbrain injuryrehabilitation.All 13 patients had surgeryand radiationand 12 also had chemotherapy.Therewere 8 malesand 5 females with a mean age of 34.3 + 10.0years and mean educationof 15.1 + 1.7 years.Mean time from tumor diagnosisto admissionfor treatmentwas 75.4 + 87.9 months.The treatment programfor these patientswas similarto approachesdevelopedfor traumaticbrain injury patients.At follow-upconductedan averageof 7.5 + 7.6 monthspostdischarge,as compared to admissionstatus,7 patientsshowedincreasedindependence,4 were unchanged,1 showed decreasedindependence,and 1 patienthad expired.Regardingproductivitystatusat followup, 9 patientsshowedincreasedproductivity,1 patientwas unchanged,2 patientsshowed decreasedproductivity,and 1 patienthad expired.Resultsshow that these patientsshowed improvementwith treatmentand these gainswere maintainedat follow-up. Tomaszewski,R. J., Lee, J., & Fratisch,N. Facilitating Effective Behavioral Intervention Within the Acute Rehabilitation Treatment Milieu.
Whilenumerousbehavioralinterventionshaveconceptualrelevanceto the problemsencounteredin AcuteRehabilitation(McGlynn,1990),the pragmatic of implementinga behavioral interventionwithin the Acute Rehabilitationtreatmentmilieu have not been specifically addressed.In the present study,the behavioralinterventionwas conceptualizedas taking place within the milieu (Prigatano& Schacter,1991)rather than simplyupon the patient. Thus,a behavioralcore groupof interestedteammembersparticipatedin behaviormeetings