Thrombolysis and visual neglect after right hemisphere infarct during a 6-month follow-up

Abstract

We explored the association of thrombolysis with the occurrence of and recovery from visual neglect and associated symptoms, specifically initial ipsilateral orienting bias and slowed processing speed within six months after first-ever right hemisphere infarct. Sixty-two patients, matched for age, years of education and baseline stroke severity, were divided into two groups according whether receiving thrombolysis or not. Visual neglect was assessed with the Behavioral Inattention Test, ipsilateral orienting bias with starting point in cancelation tasks, and processing speed with cancelation time at the acute phase and six months post-stroke. At the acute phase, thrombolytic patients scored significantly better than non-thrombolytic patients with neglect measurements used. The groups did not differ according to starting points or cancelation times. At six months, the groups did not differ according to neglect measurements or starting points. However, thrombolytic patients were significantly faster than non-thrombolytic patients in performing the letter cancelation task. The results indicate association of thrombolysis with less visual neglect symptoms at the acute phase and faster visual search performance at six months. These results support preliminary indications of an association between thrombolysis and favorable short-term cognitive outcomes but also offer first indications of a long-term association between thrombolysis and beneficial cognitive outcome post-stroke.