BACKGROUND: Previous studies reported that frontal-temporal-parietal-occipital pathological changes and diseased range in the right cerbral hemisphere were correlated with neglect.But studies on the correlation of neglect with diseased region and area in patients who suffer from initial attack of single focus of cerebral infarction(CI) in left and right cerebral hemispheres are few.OBJECTIVE: To observe the status of neglect in patients who suffer from single focus of CI in cerebral hemisphere and analyze the correlation of neglect with diseased region and area of CI.DESIGN: Case analysis SETTING: Treatment Center for Cardiocerebrovascular Disease,Second Hospital of Xiamen city;Department of Neurology,First Hospital Affiliated to Baotou Medical College.PARTICIPANTS: All the CI patients hospitalized in the Department of Neurology.First Hospital Affiliated to Baotou Medical College from June 1998 to May 2001 were retrieved.Inclusive criteria:①Patients who suffered from initial attack of CI.which was confirmed by skull CT or MRI within 24 hours after onset and presented single focus in cerebral hemisphere. ②be conscious and could cooperate in the examination. ③did not receive formal education, but could do accounts and some simple writing and reading. ④Patients with homonymous hemianopia were excluded through the examination of perimeter.⑤Informed consents were obtained from all the patients.Among 67 patients who met the inclusive criteria.33 suffered from CI in the left cerebral hemisphere and 34 in the right cerebral hemisphere.METHODS:①Patients received neglect supplement examination and Chinese aphasia examination within 2.5 to 3 months after the attack of CI.The diagnostic criteria of neglect in the tests of line cancellation. 1ine bisection and copying the figures were as follows:In the line cancellation test based on the method of Albert.patients who could not cancel one or more lines were regarded as abnormal.In the line bisection test based on the method of Peter.patients who left deviated 1.16% or right deviated 2.51% were regarded as abnormal.In the test of copying the figures,round-shape,square,cruciform and other shapes were asked to be copied, defect appeared in the figure was regarded as abnormal.The diagnostic criteria of aphasia were according to the diagnostic method of Chinese aphasia examination and type identification flow-sheet of aphasia. Infarct area was calculated based on Palisino formula: infarct area=π/6×the longest diameter of infarct area×the widest diameter of infarct area×the number of CT positive layer.②Chi-square test was used for compadng the difference of measurement data.MAIN OUTCOME MEASURES:Diseased region and area of CI and their correlations with neglect.RESULTS:Sixty-seven patients were involved in result analysis.①The correlation of the occurrence of neglect with the diseased regions of CI:Neglect was not found in 33 patients with CI in left cerebral hemisphere.but was found in 7 of 34 patients with CI in right cerebral hemisphere.The diseased regions involved right temporoparietal region,temporal-parietal-occipital region,frontal-temporal-parietal region,frontal-temporal-parietal-occipital region,temporoparietal basal nucleus,basal nucleus and dorsal caudate putamen.②The correlation of the occurrence of neglect with diseased area:infarcl area≤30 cm3 was found in 2 patients with neglect(12.5%).infarct area at 31 to 60 cm3 in 1 patient with neglect(14.3%),infarct area≥61 cm3 in 4 patients with neglect (36.4%).There was no significant difference in infarct area among groups(P＞0.05).CONCLUSION:①Right cerebral hemisphere takes advantage in spatial attention.②Neglect is more possibly caused by the combined pathological changes in temporal and parietal lobe.Temporal and parietal lobes may not cause neglect independently,but the occurrence of neglect is not directly correlated with infarct area.