Acta Neurol Scand 2001: 104: 136–141 Copyright # Munksgaard 2001

Printed in UK. All rights reserved

ACTA NEUROLOGICA
SCANDINAVICA
ISSN 0001-6314

Predictors of discharge to home during the

first year after right hemisphere stroke
Jehkonen M, Ahonen J-P, Dastidar P, Koivisto A-M, Laippala P, Vilkki
J, Molnár G. Predictors of discharge to home during the first year after
right hemisphere stroke.
Acta Neurol Scand 2001: 104: 136–141. # Munksgaard 2001.
Objectives – The aim of this study was to explore predictive factors of the
length of hospital stay at the acute stage of right hemisphere stroke.
Special attention was paid to the possible role of anosognosia for
hemiparesis and anosognosia for neglect in this prediction. Patients and
methods – A consecutive series of 57 patients having their first right
hemisphere stroke were examined at the acute phase. Forty-nine patients
were included in this study and followed-up for 12 months. The
examinations were conducted within 2 weeks of onset. The outcome
variable was the time (days) from stroke to discharge to home. The
predictors were age, gender, size of infarct, neglect, hemiparesis, verbal
memory, unawareness of illness, anosognosia for neglect, anosognosia
for hemiparesis and presence of a relative at home. Results – Hemiparesis
and unawareness of illness lengthened the duration of the hospital stay,
the presence of a relative reduced it. Neglect was the best single predictor
of poor outcome, but it had no additional value in the combination of
the three predictors above. Neither anosognosia for hemiparesis nor
anosognosia for neglect were important predictors. Conclusion –
Hemiparesis, unawareness of illness and presence of a relative at home
were the best predictors of the time from right hemisphere stroke to
discharge to home.
M. Jehkonen1,2, J.-P. Ahonen2,
P. Dastidar3, A.-M. Koivisto4,
P. Laippala4, J. Vilkki5, G. Molnár2
1
University of Tampere, Department of Psychology,
and 2Tampere University Hospital, Department of
Neurology and Rehabilitation, Tampere, Finland;
3
Tampere University Hospital, Department of
Diagnostic Radiology, Tampere, Finland; 4Tampere
School of Public Health, University of Tampere, and
Research Unit, Tampere University Hospital, Tampere,
Finland; 5University of Helsinki, Department of
Psychology, and Helsinki University Central Hospital,
Department of Neurosurgery, Helsinki, Finland
Key words: cognitive disorders; stroke; discharge to
home; neglect; anosognosia
Dr Mervi Jehkonen, Tampere University Hospital, P.O.
Box 2000, FIN-33521 Tampere, Finland
Tel.: +358 3 247 6498
Fax: +358 3 247 5314
e-mail: klmeje@uta.fi
Accepted for publication April 5, 2001

Independent living is often used as a measure of
outcome after stroke. Patients’ dependence is most
typically defined in terms of the degree of physical
disability and impairment in activities of daily living
(ADL) (1–8). It is evident that both cognitive
impairments and sensorimotor defects increase the
likelihood of dependence after stroke (6, 7, 9–11).
Earlier studies have usually included patients with
left and right hemisphere stroke. Severe hemiparesis
and aphasia clearly restrict independent living (10,
12–14). Neglect, which is a typical cognitive deficit
after right hemisphere stroke, seems to make it more
difficult to regain independence in activities of daily
living (9) or return to home after discharge from
hospital (8). Friedman (8) reported that patients
with neglect in line bisection had poorer functional
outcome as measured by Barthel ADL score,
walking speed and discharge residence than those
with normal line bisection. However, accounting for
motor loss and the ability to draw a house, line
bisection did not contribute significantly to the
prediction of functional outcome.
Pedersen et al. (15) found that hemineglect per se
had no independent influence on the discharge
Barthel Index or the rate of discharge to indepen-
dent living in their large series of patients with right
or left hemisphere stroke. In fact, they reported that
anosognosia for hemiparesis and/or visual field
defect has an independent influence on the rate of
discharge to independent living (16). Gialanella &
Mattioli (17) also found that anosognosia is the
worst prognostic factor for motor and functional
recovery from left hemiplegia after stroke.
The purpose of this study was to explore factors
connected with the return to home after right
hemisphere stroke. The outcome variable was the
time from stroke to the discharge to home during a
1-year follow-up. In particular, we wanted to find
out whether anosognosia has additional predictive
value besides neglect and hemiparesis, as suggested

136

by Pedersen et al. (15, 16), and whether these
predictive deficits might explain patients’ depen-
dency during the follow-up.
Patients and methods
Patients
Fifty-seven consecutive patients with acute right
hemisphere brain infarct were studied between
February, 1994 and March, 1998. They were
admitted to Tampere University Hospital as
emergency cases and treated at the Department of
Neurology. The patients with previous neurological
disorders, insufficient cooperation due to reduced
consciousness, severe primary visual impairment,
left-handedness and age over 75 years were
excluded. Neuropsychological and neurological
assessments were carried out within 10 days of
onset (mean=6.1; SD=1.97; range=2–10). A
follow-up study was conducted 12 months after
onset. None of the patients had recurrent stroke
during the 1-year follow-up. All patients were able
to manage independently in the activities of daily
living before the onset of stroke. Participation was
voluntary and all participants gave their written
informed consent. The study was approved by the
Ethical Committee of Tampere University Hospital.
One patient had developmental dyslexia that
clearly disturbed his performance in the Behav-
ioural Inattention subtests (18–20) requiring read-
ing, but he did not show signs of neglect. He did not
have hemiparesis and he was discharged from the
hospital 6 days after onset. This patient was
excluded from the further analyses. Five patients
had infarction in the pons and they were also
excluded. Thus we had 51 patients in the acute
examination. Two patients died during the 1-year
follow-up. One of them returned home 4 days after
stroke and this was considered his outcome. He
lived independently until his death 11 months after
stroke. The other patient remained in the hospital
and died 4.5 months after stroke. Her outcome was
considered a failure to return home. These 2
patients were included in the study, but their
exclusion did not change the results. Two patients
were excluded from the analyses because they
refused to participate in the 12-month follow-up
and therefore their discharge destination was
unknown. Thus the total number of patients in
this study was 49.
Neuropsychological examination
Presence of neglect was determined with the
Behavioural Inattention test (BIT) (18–20). The
BIT consists of six conventional subtests (BITC)
Predictors of discharge to home
and nine behavioural subtests (BITB). The conven-
tional subtests are line crossing, letter cancellation,
star cancellation, figure and shape copying, line
bisection and representational drawing. The beha-
vioural subtests are picture scanning, telephone
dialling, menu reading, article reading, telling and
setting the time, coin sorting, address and sentence
copying, map navigation and card sorting. Patients
who scored under the original cutoff in at least two
of the six BITC subtests or patients scoring under
the original cutoff (j67) in BITB subtests were
considered neglect patients (18).
Unawareness of neglect was assessed by asking
the patient directly: ‘‘Do you have any difficulties
observing any part of the space around you?’’ (21).
If necessary, the patient was given the following
alternatives: left side, right side, none or both sides.
Our single question for the observation of anosog-
nosia for neglect is comparable to the procedure of
Bisiach et al. (22) and Pedersen et al. (15, 16) for the
detection of moderate to severe anosognosia (for
hemiparesis and/or visual field defect).
Unawareness of illness and unawareness of
hemiparesis were assessed using Cutting’s (23)
questions. Patients were considered to be unaware
of illness if they gave inadequate answers to either
of the two questions: ‘‘Why are you here?’’ and
‘‘What is the matter with you?’’.
If patients with hemiparesis gave inadequate
answers to any of the following seven questions,
they were considered to be unaware of hemiparesis:
‘‘Is there anything wrong with your arm or leg?’’;
‘‘Is it weak, paralyzed or numb?’’; ‘‘How does it
feel?’’; (Arm picked up) ‘‘What is this?’’; ‘‘Can you
lift it?’’; ‘‘You clearly have some problem with
this?’’; (Asked to lift arms) ‘‘Can’t you see that your
two arms are not at the same level?’’.
Verbal memory was assessed with the Logical
Memory subtest (range=0–46 points) of the
Wechsler Memory Scale (WMS) (24).The outcome
measure was the time (in days) from stroke to being
discharged to home.
Neurological and neuroradiological examinations
A neurological examination was performed on the
same day as the neuropsychological assessment or
not more than 1 day before or after that assessment.
The degree of motor defect was evaluated using the
NIH Stroke Scale (25, 26) at the acute stage (2–10
days) and 12 months after the infarct. Hemiparesis
was scored using a scale from 0 (=normal) to 4
(=severe hemiparesis) for leg and arm separately,
and these scores were summed to give a range from
0 to 8. For statistical analyses hemiparesis scores
were dichotomized (cutoff score: 1): presence of
137
Jehkonen et al.

Table 1. Patients’ demographic and clinical characteristics at 10-day examination

Outcome at 1-year follow-up

Variables Total series Independent Dependent

Number of patients 49 47 2
Female gender 19 (39%) 17 2
Hemiparesis 14 (29%) 12 2
Anosognosia for hemiparesis 7 (14%) 5 2
Neglect (BITB) 13 (27%) 11 2
Neglect (BITC) 19 (39%) 17 2
Anosognosia for neglect (BITC) 13 (27%) 12 1
Unawareness of illness 6 (12%) 4 2
Relative at home 36 (73%) 35 1
Size of infarction (cm3): mean (SD) 58.7 (69.9) 51.5 (60.6) 229.0 (71.0)
Verbal memory (WMS): mean (SD) 19.8 (6.7) 20.4 (6.3) 7.5 (3.5)
Age: mean (SD) 62.6 (10.5) 62.2 (10.5) 73.5 (2.1)

Abbreviations: BITC=the conventional subtests of the Behavioural Inattention Test; patients scoring under the cutoff in at least two of the BITC subtests were considered
neglect patients. BITB=the behavioural subtests of the Behavioural Inattention Test; patients scoring under the cutoff (67) were considered neglect patients. WMS=Wechsler
Memory Scale; Logical Memory subtest.

hemiparesis was scored as 1, absence of hemiparesis
as 0.
Computed tomography of the brain was per-
formed on all patients. Out of the 49 patients
included in the study 45 had also magnetic
resonance imaging of the brain. On average the
neuroradiological studies were carried out 6 days
after onset (SD=2.6; range=0–12). The sizes of the
infarctions were determined on the basis of the T2
weighted MRI images by manual tracing, or when
digital images were not available (n=10), on the
basis of the CT images using a method described by
Broderick et al. (27).
Data analysis
The statistical analyses were performed with the
Cox regression model (28). The outcome variable
was the number of days from the onset of stroke to
returning home. The follow-up time was 1 year. The
predictors were age, gender, presence of a relative (a
person living with the patient), neglect, hemiparesis,
verbal memory, unawareness of illness, and size of
infarct. Anosognosia for neglect and anosognosia
for hemiparesis were studied separately as predic-
tors.
The predictive significance of each variable
separately was determined with the Cox model.
Thereafter the best combination of predictors was
computed using the forward stepwise Cox model
(probability of F to enter=0.05 and probability of F
to remove=0.10). The statistical analyses were
performed using SPSS/Win Version 9.0 Software
(29).
Results
Table 1 describes the patients’ demographic and
clinical characteristics. Forty-seven (96%) patients
returned home during the 12-month follow-up,
and the time from stroke to returning home
varied from 3 to 177 days (mean=32.1 days;
SD=41.8; median=10.0 days). Two (4%) patients
did not return to home. Thirteen patients showed
anosognosia for neglect (according to BITC
neglect criteria) reporting difficulties when obser-

Table 2. Prediction of returning home with each predictor variable separately

Predictor Hazard rate 95% CI for hazard rate P-value

Neglect (BITC) 0.21 (0.10, 0.44) <0.001

Neglect (BITB) 0.08 (0.03, 0.25) <0.001
Hemiparesis 0.14 (0.06, 0.32) <0.001
Size of infarction 0.99 (0.98, 0.99) 0.001
Unawareness of illness 0.16 (0.05, 0.53) 0.003
Gender (F vs M) 0.49 (0.25, 0.95) 0.034
Verbal memory (WMS) 1.04 (1.00, 1.08) 0.042
Relative at home 1.90 (0.98, 3.71) 0.059
Age 0.99 (0.97, 1.02) 0.682

Abbreviations: BITC=the conventional subtests of the Behavioural Inattention Test; patients scoring under the cutoff in at least two of the BITC subtest were considered
neglect patients. BITB=the behavioural subtests of the Behavioural Inattention Test; patients scoring under the cutoff (67) were considered neglect patients. WMS=Wechsler
Memory Scale; Logical Memory subtest. CI=confidence interval.

138

Table 3. Best set of predictors in the acute stage of right hemisphere infarct for
returning home
95% CI
Predictors HR for HR
Hemiparesis 0.05 (0.01, 0.16)
Unawareness of illness 0.10 (0.03, 0.42)
Relative at home 2.64 (1.27, 5.51)
Abbreviations: CI=confidence interval. HR=hazard rate.
ving the left side. None of the patients reported
difficulties observing the right or both sides in the
first examination. No infarction was visualized in
2 patients, but both of them had mild sensory and
motor disorders in the acute phase. Eight patients
had two right hemisphere infarcts.
Table 2 shows the significance of each predictor
alone. Neglect (BITC and BITB), hemiparesis,
size of infarction, unawareness of illness, female
gender and poor verbal memory were statistically
significant single predictors, which decreased the
possibility to return home and lengthened the
time of the stay in hospital or nursery home.
Table 3 illustrates the best combination of
predictors, when age, gender, neglect (BITB or
BITC separately), hemiparesis, size of infarction,
unawareness of illness, verbal memory and
presence of a relative were used as possible
predictors in the model. The significant predictors
were hemiparesis, unawareness of illness and
presence of a relative. Hemiparesis and unaware-
ness of illness decreased and the presence of a
relative increased the patients’ likelihood of being
discharged to home soon after stroke. Neglect
(BITC or BITB) was the most powerful predictor
in the first phase, but when unawareness of illness
entered into the model, the significance of neglect
vanished. All patients who were unaware of illness
in the acute stage (n=6) had also neglect
according to both neglect criteria, BITC and
BITB.
We also examined whether anosognosia for
neglect and/or anosognosia for hemiparesis pre-
dicted return to home. The analyses were
computed separately for neglect patients (n=19,
according to BITC) and hemiparetic patients
(n=14). Comparisons were made between those
patients who were aware of the deficit (neglect or
hemiparesis) and those who were unaware of the
deficit. The results indicated that anosognosia for
neglect was not related to discharge to home
(P=0.40), but anosognosia for hemiparesis was
(HR=0.28; P=0.05; 95% CI: 0.08, 0.98). Patients
with anosognosia for hemiparesis had a greater
risk for a longer hospital stay than those who
were aware of their hemiparesis.
Predictors of discharge to home
The role of anosognosia for hemiparesis as a
predictor was also examined in the total series of 49
patients. For this purpose hemiparesis was categor-
P-value ized into three groups: 0=no hemiparesis, 1=hemi-
paresis without anosognosia, and 2=hemiparesis
<0.001 with anosognosia.The rest of the predictors were the
0.002
same as in Table 2. The results indicated that
0.010
hemiparesis, unawareness of illness (HR=0.11;
P=0.002; 95% CI: 0.03, 0.46), presence of a relative
(HR=3.15; P=0.004; 95% CI: 1.43, 6.92) and size
of infarction (HR=0.99; P=0.05; 95% CI: 0.99,
1.00) were the best predictors. Hemiparesis as such
was a significant predictor, but anosognosia for
hemiparesis had no significant effect (‘‘hemiparesis
without anosognosia’’ compared to ‘‘no hemipar-
esis’’ HR=0.06; 95% CI: 0.01, 0.23 and ‘‘hemi-
paresis with anosognosia’ compared to ‘‘no
hemiparesis’’ HR=0.08; 95% CI: 0.02, 0.39).
Discussion
The aim of the present study was to explore factors
associated with the time from right hemisphere
stroke to return to home during a 1-year follow-up.
The best combination of predictors was hemipar-
esis, unawareness of illness, and the presence of a
relative at home. Hemiparesis and unawareness of
illness decreased and the presence of a close person
at home increased the likelihood of returning home
soon. Moreover, neglect (BITB and BITC) and size
of infarction had predictive value as single vari-
ables, but they were closely associated with
unawareness of illness and did not have indepen-
dent predictive value in the above mentioned
predictor combination.
Unawareness of illness was the only cognitive
deficit included in the set of best predictors. There
were 6 patients who were unaware of the illness in
the acute phase, and they all also had neglect
according to both our neglect criteria, BITC and
BITB. They had larger infarctions than the patients
who were aware of the stroke. Three of the patients
who were unaware of the illness had severe
hemiparesis, 1 had moderate hemiparesis and 2
had no motor impairment. It should be noted that
unawareness of the illness recovered rapidly. None
of the patients was unaware of the illness at the
3-month follow-up (21). Consequently, unaware-
ness of illness cannot be the cause of long-term
dependence on constant help in daily living.
Nevertheless, unawareness of illness is most prob-
ably an indicator of severe stroke, causing persistent
cognitive deficits and increasing the likelihood of
poor outcome after the awareness of illness becomes
adequate.
139
Jehkonen et al.
Some previous studies (15–17) suggest that
neglect does not have independent prognostic
significance among other predictors of functional
outcome. Indeed, Pedersen et al. (16) and Gialanella
& Mattioli (17) found that anosognosia primarily
decreased the likelihood of returning to indepen-
dent living after stroke. Pedersen et al. (16) defined
anosognosia as unawareness of hemianopia and/or
unawareness of hemiparesis. Anosognosia for one
or both of these defects was evidently a powerful
predictor, but this analysis did not reveal the
predictive significance of anosognosia for each of
the defects separately compared to the predictive
significance of the visual field or motor defect itself
without anosognosia. In our series, which only
included patients with right hemisphere infarct,
anosognosia for neglect did not have a significant
role in the prediction of returning home. The
patients who were unaware of hemiparesis had
significantly poorer outcome than those who were
aware of hemiparesis, but anosognosia for hemi-
paresis did not increase the accuracy of the best
predictor combination.
According to our previous study (30) neglect in
acute right hemisphere stroke is an important
predictor of poor functional recovery measured
with the Frenchay Activities Index (31), in which
patients evaluate their level of functional activity.
This subjective evaluation was best predicted by
neglect (BITB) and age. In the present study, using
the time from stroke to discharge to home as an
outcome measure, neglect (BITC or BITB) reached
statistical significance only as a single predictor, but
it did not improve the accuracy of the best
combination of predictors, namely hemiparesis,
unawareness of illness and presence of a relative.
Our outcome variable – the time from stroke to
discharge to home – may be affected by a number of
factors that are unrelated to the patients’ condition
during the follow-up. For instance, the rehabilita-
tion wards to which the patients were moved from
the acute neurological ward, may have different
discharge policies. On the other hand, the time from
stroke to discharge is a realistic outcome measure.
Patients would not be kept on wards for longer than
was absolutely necessary for sufficient recovery, and
those discharged too early would return to hospital
or the nursery home.
This outcome measure differs considerably from
the Frenchay Activities Index (31) that we used in
our previous study (30). The latter indicates
patients’ opinion of their activity and competence,
whereas the time from stroke to discharge is based
on a professional assessment of the patients’ ability
to manage at home. Though the circumstances at
home vary and should be taken into account, this
140
outcome measure is most probably more objective
than the self-evaluated index. Returning home
requires some basic skills and once the patient has
mastered these skills he or she can be discharged
quite soon, especially if there is a relative to help.
However, the Frenchay Activities Index (31) also
measures several outdoor activities which might
reflect a wider range of abilities. It is therefore not at
all surprising that the acute predictors of the two
outcome measures differ in the same series of
patients.
Depression is a frequent consequence of stroke,
which might be associated with poor long-term
outcome (32, 33); however this was beyond the
scope of our study. We were primarily interested in
the predictive value of acute disorders.
Measurement of depression a few days after
stroke would probably produce highly unreliable
results because this disorder usually develops
several weeks or months after onset. The result of
this study suggests that at the acute stage of right
hemisphere stroke motor functioning is the most
important factor in the evaluation of patients’
discharge to home. Cognitive factors seem to have a
less important role in this prediction. However,
unawareness of illness that was associated with
severe neglect lengthened the patients’ hospital stay.
Acknowledgements
This study was supported by grants from the Medical
Research Fund of Tampere University Hospital, the Finnish
Cultural Foundation, the Scientific Research Fund of the
City of Tampere and the Finnish Graduate School of
Psychology.
References
1. KELLY-HAYES M, WOLF PA, KANNEL WB, SYTKOWSKI P,
D’AGOSTINO RB, GRESHAM GE. Factors influencing survival
and need for institutionalization following stroke: The
Framingham Study. Arch Phys Med Rehabil 1988;69:
415–18.
2. WADE DT, HEWER RL. Functional abilities after stroke:
Measurement, natural history and prognosis. J Neurol
Neurosurg Psychiatry 1987;50:177–82.
3. DE HAAN R, AARONSON N, LIMBURG M, HEWER RL, VAN
CREVEL H. Measuring quality of life in stroke. Stroke
1993;24:320–7.
4. DE HAAN R, LIMBURG M, BOSSUYT P, VAN DER MEULEN J,
AARONSON N. The clinical meaning of Rankin ‘‘Handicap’
Grades after stroke. Stroke 1995;26:2027–30.
5. NAKAYMA H, JÖRGENSEN HS, RAASCHOU HO, OLSEN TS. The
influence of age on stroke outcome. The Copenhagen
Stroke Study. Stroke 1994;25:808–13.
6. POHJASVAARA T, ERKINJUNTTI T, VATAJA R, KASTE M. Corre-
lates of dependent living 3 months after ischemic stroke.
Cerebrovasc Dis 1998;8:259–66.
7. TATEMICHI TK, DESMOND DW, STERN Y, PAIK M, SANO M,
BAGIELLA E. Cognitive impairment after stroke: frequency,

patterns, and relationship to functional abilities. J Neurol
Neurosurg Psychiatry 1994;57:202–7.
8. FRIEDMAN PJ. Spatial neglect in acute stroke: the line
bisection test. Scand J Rehab Med 1990;22:101–6.
9. KOTILA M, NIEMI M-L, LAAKSONEN R. Four-year prognosis
of stroke patients with visuospatial inattention. Scand J
Rehab Med 1986;18:177–9.
10. DE JONG G, BRANCH LG. Predicting the stroke patient’s
ability to live independently. Stroke 1982;13:648–55.
11. SUNDET K, FINSET A, REINVANG I. Neuropsychological pre-
dictors in stroke rehabilitation. J Clin Exp Neuropsycho-
logy 1988;10:363–79.
12. PAOLUCCI S, ANTONUCCI G, GIALLORETI LE et al. Predicting
stroke inpatient rehabilitation outcome: The prominent role
of neuropsychological disorders. Eur Neurol 1996;36:
385–90.
13. PAOLUCCI S, ANTONUCCI G, PRATESI L, TRABALLESI M, LUBICH
S, GRASSO MG. Functional outcome in stroke inpatient
rehabilitation: predicting no, low and high response
patients. Cerebrovasc Dis 1998;8:228–34.
14. WADE DT, HEWER RL, DAVID RM, ENDERBY PM. Aphasia
after stroke: natural history and associated deficits. J
Neurol Neurosurg Psychiatry 1986;49:11–16.
15. PEDERSEN PM, JÖRGENSEN HS, NAKAYMA H, RAASCHOU HO,
OLSEN TS. Hemineglect in acute stroke – incidence and
prognostic implications. The Copenhagen Stroke Study.
Am J Phys Med Rehabil 1997;76:122–7.
16. PEDERSEN PM, JÖRGENSEN HS, NAKAYMA H, RAASCHOU HO,
OLSEN TS. Frequency, determinants, and consequences of
anosognosia in acute stroke. J Neuro Rehab 1996;10:243–
50.
17. GIALANELLA B, MATTIOLI F. Anosognosia and extrapersonal
neglect as predictors of functional recovery following right
hemisphere stroke. Neuropsychological Rehabilitation
1992;2:169–78.
18. WILSON B, COCKBURN J, HALLIGAN PW. Behavioural
Inattention test. Manual. Titchfield, UK: Thames Valley
Test Company, 1987.
19. WILSON B, COCKBURN J, HALLIGAN P. Development of a
behavioural test of visuo-spatial neglect. Arch Phys Med
1987;68:98–102.
20. HALLIGAN P, COCKBURN J, WILSON B. The behavioural
Predictors of discharge to home
assessment of visual neglect. Neuropsychological Rehab-
ilitation 1991;1:5–32.
21. JEHKONEN M, AHONEN J-P, DASTIDAR P, LAIPPALA P, VILKKI J.
Unawareness of deficits after right hemisphere stroke:
Double-dissociations of anosognosias. Acta Neurol Scand
2000;102:378–84.
22. BISIACH E, VALLAR G, PERANI D, PAPAGNO C, BERTI A.
Unawareness of disease following lesions of the right
hemisphere: anosognosia for hemiplegia and anosognosia
for hemianopia. Neuropsychologia 1986;24:471–82.
23. CUTTING J. Study of anosognosia. J Neurol Neurosurg
Psychiatry 1978;41:548–55.
24. WECHSLER D. A standardised memory scale for clinical use. J
Psychology 1945;19:87–95.
25. BROTT T, ADAMS HP, OLINGER CP et al. Measurements of
acute cerebral infarction: a clinical examination scale.
Stroke 1989;20:864–70.
26. GOLDSTEIN LB, BERTELS C, DAVIS JN. Interrater reliability of
the NIH Stroke Scale. Arch Neurol 1989;46:660–2.
27. BRODERICK JP, BROTT TG, DULDNER JE, TOMSICK T, HUSTER
G. Volume of intracerebral hemorrhage. A powerful and
easy-to-use predictor of 30-day mortality. Stroke 1993;24:
987–93.
28. COX DR, OAKES D. Analysis of Survival Data. London:
Chapman and Hall, 1984.
29. SPSS for Windows 9.0. Advanced Models. Chicago: SPSS
Inc, 1999;75–81.
30. JEHKONEN M, AHONEN J-P, DASTIDAR P et al. Visual neglect
as a predictor of functional outcome one year after stroke.
Acta Neurol Scand 2000;101:195–201.
31. SCHULING J, DE HAAN R, LIMBURG M, GROENIER KH. The
Frenchay Activities Index. Assessment of functional status
in stroke patients. Stroke 1993;24:1173–7.
32. ANDERSEN G, VESTERGAARD K, RIIS JO, LAURITZEN L.
Incidence of post-stroke depression during the first year
in a large unselected stroke population determined using a
valid standardized rating scale. Acta Psychiatr Scand 1994;
90:190–5.
33. KOTILA M, NUMMINEN H, WALTIMO O, KASTE M. Post-stroke
depression and functional recovery in a population-based
stroke register. The Finnstroke study. European Journal of
Neurology 1999;6:309–12.
141