The superior parietal lobule (SPL) plays a strategic role in somatosensory and visuomotor integration. This study aims to evaluate the clinical, neurocognitive, and behavioral characteristics of isolated SPL stroke.

We assessed neuropsychological and behavioral findings in 14 patients with isolated SPL stroke among 4200 patients with ischemic stroke. All patients underwent neuroimaging, clinical and neuropsychological assessment after stroke.

Of the 14 patients enrolled, the first complaints were tactile and visuospatial disorders at stroke onset. Except for 6 patients with only 1 cognitive impairment, the majority of patients (57%) experienced more than 1 cognitive impairment category. Functional hemispheric asymmetries have been found in different cognitive processes, such as between visuospatial and body image functions and language process. Among visuospatial abilities disorders, spatial disorientation, visuospatial neglect, and visual extinction were found in two-thirds (63%) of patients with right SPL lesion. Body schema and image disorders were observed in all patients with right-sided lesions, such as alien hand, autotopagnosia for body parts (36%), autotopagnosia for sensory sensations (36%), and fading limb (21%). Two-thirds (57%) of patients with left SPL had impairment in language abilities.

Our findings after stroke suggest that SPL plays a pivotal role in the regulation of visuospatial abilities, body schema and body image processing, and language skills through bilateral frontoparietal networks and interhemispheric parietal networks.

Survivors of patients with artery of Percheron infarction (API) often have a prolonged and disabling form of cognitive impairment that remains insufficiently characterized. We aimed to examine the clinical and cognitive features of API in the short and long term after stroke.

We reviewed 6400 patients with a first-ever stroke included in the Stroke Registry between 2011 and 2021. The diagnosis of API was based on clinical diagnosis and imaging confirmation. All patients underwent neuropsychological assessment at hospital stay and 1 year after stroke. A z-score of each patients’ cognitive test point was calculated, and a z-score inferior to 2 was considered as pathological.

Of the 10 patients enrolled, all had cognitive impairment, consciousness, and behavioral disorders at stroke onset. Six patients had pure bilateral thalamic involvement while four had bilateral thalamic and rostral midbrain involvement. At 12 months, 50% of patients had global mental state scores 2 SD below the population mean (z-score mean ± SD, −2.17 ± 0.4). Most of the prefrontal cortex cognitive processes including executive functions such as planning and cognitive control (z-score mean ± SD, −3.92 ± 0.3), processing speed (−4.42 ± 0.5), working memory (−3.97 ± 0.3) were severely impaired at stroke onset. Especially in patients with thalamic and rostral midbrain involvement, deficiencies in executive function (z-score mean ± SD, −2.60 ± 0.4), processing speed (−2.22 ± 0.5), working (−3.76 ± 0.4), and episodic memory (−2.23 ± 0.3) continued 12 months after stroke.

The occlusion of the artery of Percheron results in severe behavioral and cognitive disorders in the short and long term after stroke.