The "eye sign" due to hemispatial neglect: A case report

Abstract

Conjugate eye deviation is characterized by a sustained shift in horizontal gaze, usually toward the affected brain hemisphere. When detected on neuroimaging, it is called the “eye sign”. It is classically associated with lesions involving the frontal eye fields, ipsilateral to the side of the deviation. Neglect may be conceptualized as a spatially addressed bias of the sensory events in explicit behaviors and in the absence of perceptual and motor deficits. Hemispatial neglect is a common disabling condition that occurs following acute unilateral brain damage, usually to the right side. We report a case of a patient presenting with the “eye sign” on tomography, following an acute subinsular stroke, in the absence of conjugated eyes deviation. Our hypothesis was that the sign may have been due to hemispatial neglect in this patient. The aim of this article was to discuss the mechanisms involved in the attention network and its neuroanatomic correlates.

Neuroimaging of eye position reveals spatial neglect: a commentary

“…She was treated with recombinant tissue plasminogen activator, resulting in improvement of neurological deficits. At follow-up 24 h later, brain MRI confirmed an infarct in the right insular subcortical region (subinsular territory) (Porto et al, 2009). We hypothesize that, during the performance of CT, the symmetrical visual stimuli may had provoked left-side visual extinction or that closure of the eyes or even darkness may have caused biased ocular searching mechanism that gave rise to gaze deviation (Hornak, 1999).…”