title: Functional cerebral space theory: Towards an integration of theory and mechanisms of left hemineglect, anosognosia, and anosodiaphoria.
abstract: BACKGROUND
  The current case study presents a 43 year old African American woman admitted to a Tertiary Care Rehabilitation unit at a major medical center for concerns over left-sided anesthesia and weakness. Head scans indicate a right middle cerebral arterial distribution infarct altering blood flow in temporal, parietal, and occipital regions in the right cerebral hemisphere.
  
  
  OBJECTIVE
  Physician and therapist reports (i.e., speech and occupational therapists) referred the patient for a neuropsychological evaluation for concerns over the patient's capacity to recognize the severity of her deficits and self-care, with potential rule-outs indicated by the extant literature on right CVA for anosognosia, anosodiaphoria, and left hemibody/hemispace neglect.
  
  
  METHODS
  The current case integrates interdisciplinary physician notation, magnetic resonance imaging and magnetic resonance angiogram, observations and reports from speech and occupational therapy, and neuropsychological assessment via standardized tests and neurobehavioral syndrome analysis.
  
  
  RESULTS
  Evidence was found for co-occurring syndromes of moderate anosognosia, anosodiaphoria, and left hemibody/hemispatial neglect derived from shared functional cerebral space with overlapping temporal, parietal, and occipital damage.
  
  
  CONCLUSIONS
  Clinical implications are discussed, including recommendations for therapy approaches based on functional cerebral space theory that may indicate the use of known techniques (e.g., for left hemibody neglect) that may also have therapeutic implications for treating other, more mercurial co-occurring syndromes of anosognosia and anosodiaphoria.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Smith
authors.forename: Ransom W
authors.initials: RW
authors.lastname: Campbell
authors.forename: Patti Kelly
authors.initials: PK
authors.lastname: Harrison
authors.forename: David W
authors.initials: DW
authors.lastname: Harrison
mesh_terms: D000328:Adult; D000377:Agnosia / Q000473:pathology* / Q000523:psychology / Q000534:rehabilitation; D001921:Brain / Q000473:pathology*; D002533:Cerebral Angiography; D002540:Cerebral Cortex / Q000473:pathology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D009788:Occupational Therapy; D010468:Perceptual Disorders / Q000473:pathology* / Q000523:psychology / Q000534:rehabilitation; D013070:Speech Therapy
keywords: Left hemineglect; anosodiaphoria; anosognosia; cerebral hemisphere; cerebrovascular accident; emotion; insight; middle cerebral artery; neglect; neglect disorders; stroke