Awareness of disease states following cerebral infarction, dementia, and head trauma: Standardized assessment

Abstract

Awareness of cognitive and motor impairments was evaluated in 100 patients with cerebral infarction, dementia, or head trauma, using a standardized interview which elicited subjects' descriptions of their condition. “Unawareness” was operationally defined as a discrepancy between the subject's description of abilities, and measurement of those abilities with neuropsychological and neurological evaluations. In all three neuropathologic groups, subjects frequently demonstrated unawareness of acquired impairments. Unawareness was associated with unilateral right-hemisphere damage, impaired performance on IQ tests, and temporal disorientation. All subjects with unawareness of hemiparesis also had unawareness of cognitive defects. It is evident that unawareness of cognitive defects is an important and common manifestation of brain disease, and systematic evaluation of this problem may aid in patient management and rehabilitation planning.