Unilateral spatial neglect associated with chronic subdural haematoma: a case report

A 69-year-old right-handed man who exhibited unilateral spatial neglect in association with a chronic subdural haematoma, presented with mild left arm and leg weakness first noted 4 weeks prior to admission. Neurologic examin ation on admission revealed a mild left hemiparesis, including the face. Ne uropsychologic examination revealed left unilateral spatial neglect, but no language disturbance. Minimal support was necessary to maintain activities of daily living. Computed tomography revealed a large right temporoparieta l, extraaxial hypodense fluid collection containing scattered hypodense foc i. The haematoma was evacuated via a right parietal burr hole. Following su rgery, the patient dramatically improved neurologically and neuropsychologi cally, as well as in independent performance of daily activities. It is sug gested that the improvement in ADL provides a behavioural correlate of impr ovement in the latter, represented a behavioural correlate of improved cere bral function, and that either direct compression by the chronic subdural h aematoma or an interhemispheric pressure difference had caused unilateral s patial neglect. Such neglect is an unusual consequence of chronic subdural haematoma.