Selective rotation of egocentric spatial representation following right putaminal hemorrhage

Post-stroke visual midline shift syndrome

The state of research on the topic of visual midline shift syndrome following a cerebrovascular accident is unknown. A scoping review was conducted using the search terms of 'visual midline shift' (or equivalent) and 'cerebrovascular accident' (or equivalent). Articles were selected from eight academic and one grey literature database, and went through two levels of review, as per Arksey and O'Malley, before being deemed acceptable for inclusion. Of the 931 abstracts reviewed, 27 articles met the criteria for inclusion. Data extracted from the selected articles included terminology and definition, symptoms, underlying pathophysiology, duration, assessment method, and management of visual midline shift syndrome following cerebrovascular accident. There is agreement on the existence of a midline shift following a cerebrovascular accident resulting in poor posture and imbalance. Much uncertainty exists in the literature regarding terminology, underlying pathophysiology, assessment method and management of this condition. Further research is required.

Clock drawing and neuroanatomical correlates: A systematic review

OBJECTIVE

The popular clock drawing test (CDT) is easy to administer, acceptable to patients, and has excellent psychometric properties. Although it has been used primarily as a cognitive screening test, many studies have attempted to establish the CDT's ability to localize specific brain lesions or pathology. This systematic review aimed to summarize the evidence on the neuroanatomical correlates of the CDT.

METHODS

Using PRISMA guidelines, the authors systematically reviewed the evidence on neuroanatomical correlates of clock drawing by a systematic search in six databases (Pubmed, CINHL, PsychINFO, HealthStar, Embase, and Web of Science) until January 2018. Studies were included if they reported CDT correlations with anatomical brain lesions documented by neuroimaging.

RESULTS

Forty-five papers met inclusion criteria. Thirty-one studies identified distinct areas of neuroanatomical correlates of CDT utilizing different scoring methods and imaging techniques. Nine articles reported on the degree of white matter hyperintensities that correlated with lower scores on CDT and the severity of cognitive deficits. Five articles focused on postacute cerebrovascular accidents correlated with CDT performance. A variety of different anatomical lesions, located in all areas of the brain, were associated with abnormalities on the CDT.

CONCLUSIONS

The CDT, regardless of scoring method and population studied, was not associated with any consistent, specific brain localization. This systematic review supports the use of the CDT as a cognitive screening test rather than a method of localizing brain lesions.