Higher-vision screening. Assum-ing that normal visual acuity has been demonstrated, a satisfactory impres-sion of a patient's global visual abilities can be gained by asking the patient to describe a visual scene. The cookie theft picture (Figure 51), from the Boston Diagnostic Aphasia Examination (pro¬vided with the NIHSS card set), is a convenient stimulus for this test.
Cookie theft picture.
"Here is a picture. I want you to tell the story of what is happening in this scene."
Interpretation: Patients should nor¬mally describe items from the left andthe right side of the picture, identify depicted items correctly, and integrate these percepts into a scene.
Record:
Normal: cookie theft picture descrip-tion, normal
Abnormal: cookie theft picture de-scription, neglects left side
Visuoperception is also testing implic-itly by visual naming and by visuocon-struction tests.
Visuoconstruction.
"I want you to draw an exact copy of this drawing."
Show picture of an occluded 3-dimensional cube. Show picture of intersecting penta¬gons. Interpretation: Normal patients copy these figures perfectly. Minor size and rotation errors should be tolerated.
Defective visuoconstruction on sim¬ple geometric figures implies dysfunc¬tion in right parietal association cor¬tex. It has the virtue of being easily recorded. (Note: If it is important to detect nonverbal memory impairment, it is also helpful to administer an abstract [unnameable] design to allow delayed testing of visual memory.)
Record:
Normal: copy of geometric figures
intact
Abnormal: copy of geometric figures
defective [attach]
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