Teaching Video NeuroImages: Posterior territory stroke with parahippocampal involvement: A neglected cause of neglect

An 87-year-old patient presented with a stroke in the right posterior territory (figure), with visual neglect, which was initially thought to be left homonymous hemianopia. The tip of the occipital lobe was spared, however, and therefore complete hemianopia was not to be expected. With a posterior stroke, neglect can easily be overlooked, although it is common in posterior strokes, when the parahippocampal gyrus is involved.1 The 2 deficits can be tested for separately by turning the body of the patient to the left and the head to the right, because the neglect is body-centered.2 (video).