Abstract: ObjectiveTo investigate the clinical features, mechanism and cerebral functional correlation of hemianopic anosognosia.Methods16 patients with homonymous visual field defects due to ischemic infarcts were examined on visual field and MMSE. The neuropsychological tests were administered such as hemianopic awareness and visual neglect. The facts were analyzed with the location of ischemic infarct documented by MRI or CT. Results10 of 16 patients with hemianopia had anosognosia of their visual deficit. 8 of 13 right side lesion patients had hemianopic anosognosia. 2 of 3 left side lesion patients had hemianopia anosognosia. 3 of 6 awareness hemianopia patients had visual hemineglect. 7 of 10 hemianopic anosognosia patients had larger infarction of middle cerebral artery. 3 else had smaller infarction in the occipital lobe or in the connective area between the occipital and temporal lobes.ConclusionsThere is no specific cortical area for conscious visual perception. Visual awareness is processed by a distributed network including multiple cortices and subcortices. Both hemispheres are involved in visual processing and conscious awareness.

Key words: hemianopic anosognosia, visual neglect, cerebral hemisphere founction