Acute loss of spatial navigational skills in a case of a right posterior hippocampus stroke

The ability to accurately navigate within an environment (known or new) is not fully understood but involves a number of highly complicated cognitive process related to both central and peripheral nervous system structures and neuronal networks. We describe a patient who developed loss of his spatial navigational skills associated with an acute ischemic right posterior hippocampal lesion. Neuropsychological assessment displayed clear evidence of impaired visuospatial/visuoconstructional abilities with relative preservation of many other cognitive functions involving orientation, language, and verbal memory. The underlying anatomy responsible for the navigational impairment seen in our patient could be due to impairment in the function of the right hippocampus to form, store, and retrieve new 'cognitive/spatial maps'. To our knowledge this is one of the few documented cases demonstrating impaired navigational abilities with a relatively discrete right-sided, posterior hippocampal lesion.