Case ReportsUpper Vertical Spatial Neglect With A Right Temporal Lobe StrokeMorris, Michael MD*,†; Mańkowska, Aleksandra MA‡; Heilman, Kenneth M. MD*,†Author Information *Division of Cognitive and Behavioral Neurology, Department of Neurology, University of Florida College of Medicine, Gainesville, Florida †Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida ‡Division of Clinical Psychology and Neuropsychology, Institute of Psychology, Department of the Social Sciences, University of Gdańsk, Gdańsk, Poland The authors declare no conflicts of interest. Correspondence: Kenneth M. Heilman, MD, Department of Neurology, Room L3-100, McKnight Brain Institute, 100 S Newell Drive, Gainesville, Florida 32611 (email: firstname.lastname@example.org). Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government. Cognitive and Behavioral Neurology: March 2020 - Volume 33 - Issue 1 - p 63-66 doi: 10.1097/WNN.0000000000000221 Buy Metrics Abstract Individuals with a hemispheric infarction often reveal inattention to, or neglect of, contralesional lateral space (ie, hemispatial neglect). Individuals with a bilateral ventral temporal-occipital lesion have been shown to demonstrate upper vertical neglect, and those with a bilateral parietal-occipital lesion have been shown to demonstrate lower vertical neglect. However, to our knowledge, there have been no reports of individuals with vertical neglect from a unilateral hemispheric lesion. We report on a 72-year-old, right-handed male who developed transient left hemiparesis. On examination, he had left facial weakness and he bisected horizontal lines to the left of the midline (ie, ipsilesional neglect). In addition, on a line bisection test involving nine vertical line bisections, he demonstrated downward deviation in the majority of the trials; healthy individuals deviate upward. On brain imaging, our patient revealed a cerebral infarction, primarily affecting the right temporal lobe; the temporal lobes contain the ventral attentional network that allocates attention upward. There is also some evidence that, whereas the right hemisphere mediates attention upward, the left mediates attention downward. Therefore, injury to the right temporal lobe may account for our patient’s upward neglect with downward deviation. However, further studies are needed to better understand the pathophysiology of vertical neglect.