"Crossed homonymous hemianopia" and "crossed left hemispatial neglect" in a case of Marchiafava-Bignami disease.

Abstract

"Crossed homonymous hemianopia" and "crossed left hemispatial neglect" were observed in a woman with Marchiafava-Bignami disease. Two forms of "crossed homonymous hemianopia" were observed. Initially, Goldmann perimeter testing showed a left homonymous hemianopia with the right hand and vice versa. Later, confrontation tests showed a left homonymous hemianopia, whereas visual field testing using the Goldmann perimeter (kinetic quantitative perimeter) and the OCTOPUS (Interzeag AG, static automated perimeter) showed a right homonymous hemianopia with either hand. "Crossed left hemispatial neglect" was not seen with the left hand, but neglect of the left hemifield was seen with the right hand. CT and MRI showed a lesion occupying almost the entire corpus callosum. PET showed no significant differences between comparable areas of the left and right cerebral hemispheres. These findings indicate that both signs of interhemispheric disconnection were due to the callosal lesion. Moreover, the "crossed left hemispatial neglect" can be explained as being a consequence of the dominance of the right cerebral hemisphere for visuospatial recognition.

Somesthetic Disconnection Syndromes in Patients with Callosal Lesions

“…None of the cases exhibited aphasia, and their ability to read aloud under conditions of free vision was excellent. Callosal signs other than somesthetic ones have been reported previously for cases 1 [4]and 2 [5, 6, 7]. …”

“…The autopsy in case 1 revealed lesions localized to the posterior truncus of the corpus callosum (for MRI of case 1, see Kawamura et al [4]). MRI in case 2 revealed lesions throughout the corpus callosum except in the rostrum [5, 6], and in case 3 it revealed lesions in the caudoventral part of the posterior truncus (fig. 3).…”

Dominance specific visual extinction associated with callosal disconnection

“…Further reports of line bisection after callosal damage showed similar 'symmetrical neglect' suggesting that, lacking interhemispheric information transfer, each hemisphere independently mediates attention-intention within and towards contralateral hemispace (Hausmann, Corballis, & Farbi, 2003). In contrast, other patients demonstrate neglect only when using the right hand for drawing, writing and target cancellation, with normal performance using the left hand (Ishiai, Koyama, & Furuya, 2001;Kamaki, Kawamura, Moriya, & Hirayama, 1993;Kashiwagi et al, 1990). These findings have been interpreted in terms of asymmetrical organization of neural mechanisms mediating spatial attention, whereby the left hemisphere attends predominantly to right space while the right hemisphere attends to both sides.…”

Description of interhemispheric disconnection syndrome in a patient with Marchiafava-Bignami disease

“…It was reported crossed homonymous hemianopia and crossed left hemispatial neglect in patient with MBD, with lesions of the entire CC except for the extreme anterior portion. He also showed apraxia, agraphia and tactile anomia of the left hand [11].…”