Зрительная объектная агнозия и агнозия новых топографических ориентиров у пациентов с острым полушарным ишемическим инсультом

Abstract

The purpose — to estimate the frequency of visual general objects agnosia and novel landmarks agnosia in patients with acute ischemic stroke and to describe the clinical manifestations of these phenomena and association between them. Materil and methods. 75 patients with ischemic stroke were enrolled. Computed tomography and/or magnetic resonance scan to confirm the ischemic lesion, neurological, ophthalmological and neuropsychological examination were performed in all patients. Visual perception skills (gnosis) were measured by Birmingham Object Recognition Battery tests and authors’ Novel landmarks recognition test. Results. 8 out of 75 patients (10,7%) had visual agnosia documented by the neuropsychological testing, of these 3 patients had question-induced complaints («clinically evident» agnosia, group 1) and 5 patients had no complaints («clinically blurred» agnosia, group 2). 67 patients (89,3%) were not agnostic (group 3). The patients of the 1st and 2nd groups performed perception (gnosis) test significantly worse compared with those of the 3rd group while group 1 demonstrated significantly worse test results than group 2. A significant positive correlation was found between the results of Birmingham Object Recognition Battery tests and the Novel landmarks recognition test. Conclusion. General objects and landmarks recognition is impaired in 10,7% patients with acute ischemic hemispheric stroke. As a rule, general object agnosia is associated with landmark agnosia. Visual general objects and landmarks agnosia may be «clinically evident» verified by the patients’ question-induced complaints as well as by the results of neuropsychological testing, or «clinically blurred», verified only by testing. The test results were statistically significantly worse in «clinically evident» than in «clinically blurred» visual agnosia.