10.1016@s0074 77420674013 2

STROKE IN PAINTERS
H. Bäzner and M. Hennerici

Department of Neurology, University of Heidelberg Universitätsklinikum Mannheim
68135 Mannheim, Germany
I. Introduction
II. Case Studies of Painters with Right Hemisphere Stroke
A. Anton Räderscheidt
B. Otto Dix
C. Johannes Thiel
D. Lovis Corinth
E. Wolfgang Aichinger-Kassek
F. Federico Fellini
G. Reynold Brown
H. Tom Greenshields
I. Schnider et al.
J. Vigouroux et al.
K. Blanke et al.
L. Guglielmo Lusignoli
M. Kurt Schwitters
III. Case Studies of Painters with Left Hemisphere Stroke
A. Paul-Elie Gernez
B. Daniel Urrabieta y Vierge
C. Zlatyu Boijadjiev
D. Ernst Oldenburg
E. Beni Ferenczy
F. Polish painter ‘‘R. L.’’
G. Afro Basaldella
H. Arnold Böcklin
I. Caspar David Friedrich
IV. Other Cases
A. The Case of an 87-Year-Old Artist
B. Tommy McHugh
C. Jon Sarkin
V. Conclusions
References
I. Introduction
A stroke may befall anyone because brain lesions caused by cerebrovascular

disease are common and can result in devastating disability. Improvements in
modern neurophysiological, neurosonological, and continuously developing
INTERNATIONAL REVIEW OF 165 Copyright 2006, Elsevier Inc.

NEUROBIOLOGY, VOL. 74 All rights reserved.
DOI: 10.1016/S0074-7742(06)74013-2 0074-7742/06 $35.00
166 BÄZNER AND HENNERICI
neuroimaging technology have led to precise lesion localization, giving a better

understanding of pathophysiological mechanisms leading to stroke. Recent de-
velopments in neuropsychology have revealed certain irregularities as a conse-
quence of stroke depending on lesion extent and localization. Although our
knowledge is growing regarding the eVects of stroke on the majority of patients,
when facing the specialized individual and highly developed skills of professional
visual artists and lacking a reasonably large patient collective, few authors have
aimed at analyzing systematically the consequences of stroke in such a group.
On the other hand, some very interesting case reports have been produced,
going back to the early twentieth century. A seminal article including the cases of
four German professional artists with right hemisphere lesions has been pub-
lished in 1974 by Richard Jung (1974) (Chapter 14 by Blanke in this volume).
Prof. Jung, chairman of the department of Neurology and Clinical Neurophysi-
ology at Freiburg University, was a clinical neurologist and researcher with a
special interest in the neurophysiology of the visual system; he was also an
amateur and collector of modern German artwork, and his study reported the
cases of Anton Räderscheidt, Lovis Corinth, Otto Dix, and Johannes Thiel.
By reviewing the literature and adding several additional cases, totaling a
number of 24 professional visual artists, we will try to comment on common
features of right versus left hemisphere damage with an emphasis on artistic
production. We are well aware of the limitations of our eVort, since the freedom
of art rarely follows simplistic rules, and as artists and art historians will not
always share the neurological point of view, we are obliged to interpret our
observations with care.
II. Case Studies of Painters with Right Hemisphere Stroke
A. ANTON RÄDERSCHEIDT
Anton Räderscheidt (October 11, 1892–March 3, 1970) started his artistic

career in Cologne, the town of his birth. His portraits and figure paintings were
shown in the famous ‘‘Neue Sachlichkeit’’ exhibition in Mannheim in 1925. He
was a protagonist of the ‘‘magic realism’’ in which persons and their surroundings
were painted close to photographic art, the emotional content being reduced to a
minimum, as opposed to the contemporary expressionistic painters. He emi-
grated from Germany in 1934 to live in Switzerland, England, and France until
1949, when he returned to Cologne with his second wife. His artistic style
changed after 1950, when he became inspired by cubism.
On September 24, 1967, shortly before a large retrospective exhibition in
Cologne, Räderscheidt suVered a stroke with severe visual disturbances and a
STROKE IN PAINTERS 167
mild left hemisyndrome. He had a left homonymous hemianopsia with left-sided

hemineglect, a disturbance of spatial orientation and an initially severe proso-
pagnosia. The problem of face recognition was so severe that he was unable to
recognize even close relatives, a problem that persisted for several weeks. Begin-
ning in December 1967 and continued over the period from January to June
1968, Räderscheidt painted an enormously large series of self-portraits with the
intention of compensating for his severe left-sided hemineglect. In Jung’s study
(1974), the improvement of his neglect was illustrated using five of these self-
portraits, set of four (Figs. 8B and 9A–C of Jung’s study) ones being later
repeatedly published (Butter, 2004; Gardner, 1977). The change in artistic style
in his late paintings displaying couples or nudes has already been discussed by
Jung, who noticed a stronger aVective relationship. Räderscheidt’s son Pascal,
who runs a remarkable website (http://www.raederscheidt.com) presenting bio-
graphical data and a large collection of his father’s artwork, says that his father
referred to these paintings as ‘‘Böse Bilder’’ (nasty paintings). Räderscheidt is
cited with the following remark concerning his stroke, ‘‘Using all of my willpower,
I intended to force my eyes to see correctly again. [. . .] A stroke has taken me
away from the scene of life; oVstage the play is going on with me. I am no longer
the director of this play. I have to take care, not to miss my entrance in the play.
My requisites obey to tricks only. Moreover, I am missing my loud colours. [. . .]
The reproduction of my surroundings is a damned diYcult thing. Nothing is
staying in its place, nothing is keeping the shape. Perhaps I will be able to get hold
of a credible shape now if I can use this permanent motion. [. . .] In the past it felt
like hunting [shape], now it feels more like catching a trout in moving water using
bare hands. [. . .] Painting is like taming beasts of prey’’ (Richter, 1972). Neuro-
logical examination was not repeated, and he died in March 1970, but Jung
assumed that his hemianopsia was unchanged and that the painter learned to
compensate for his neglect ( Jung, 1974). As to artistic expression, a total revolution
occurred after his stroke: compared to his earlier grouped figures and couples,
which are lacking any emotional content and avoid personal contact, his post-
stroke paintings are overloaded with wild colorful brushstrokes, display ecstatic
scenes, often depicting couples in close personal contact (‘‘böse Bilder,’’ Fig. 1A
and B). Persons, who had previously been painted in a very realistic manner, are
grossly deformed, the artist using brighter colors and a larger variety of colors.
B. OTTO DIX
Otto Dix (December 2, 1891–July 25, 1969) was born in Untermdorf near
Gera, studied in Düsseldorf and Dresden, and became a professor of arts of the
Dresden Academy of Arts in 1927. He was well known in his early years for his
naturalistic-veristic style, and was painting large series of war scenes, having been
FIG. 1 (A and B). Anton Räderscheidt’s post-stroke paintings display ecstatic scenes, often depicting
couples in close personal contact. Persons are grossly deformed, the artist using brighter colors and a
larger variety of colors compared to his pre-stroke art. A moderate left sided hemineglect can be noted.
Part A and B # VG Bild-Kunst, Bonn, 2006.
a soldier in the First World War. His portraits in 1920s were often over char-
acterized and displayed ugly human figures close to caricature. His paintings
were classified as ‘‘degenerate,’’ and he was forced to leave the academy of arts in
1933. He moved to the Bodensee, where he stayed over 30 years until his death
in 1969 (Schubert, 1980).
On November 13, 1967, Dix suVered a right hemisphere stroke with left-sided
hemiparesis, left hemineglect, partial hemianopsia, and mild spatio-constructive
disturbances. Moreover, a reduced proprioception and apraxia of his left arm were
noted by his treating neurologist, Prof. Gunter Baumgartner of Zürich. In the first
3 days following the stroke, Dix was unable to draw at all. On day four, after the
onset of symptoms, he could draw a simple and small sketch of a tree, with a
unilateral shadowing giving the tree a plastic appearance. The left part of the paper
was left free indicating his neglect. One week later, the neglect seemed widely
compensated in a second sketch of a tree (both sketches are documented in Dix’
patient chart in Zürich University Hospital and are reproduced in Jung, 1974), but
we cannot support Jung’s view of an unchanged drawing style. His drawing was
altered noticeably at least in his last self-portraits; self-portrait with black collar
(1968), small self-portrait (1968), self-portrait with a hand (1968), and self-portrait
as a skull (1968) all share a missing resemblance to the painter. This is substantially
diVerent from the self-portraits Dix painted in 1957 (Fig. 2B), 1964 (Fig. 2C), and
1967, whose similitude is very close to the photographs showing Dix at the
FIG. 2. Otto Dix’ drawing style was altered noticeably in his last self-portraits. Self-portrait with black
collar (1968, Fig. 2D), small self-portrait (1968, Fig. 2F), self-portrait with a hand (1968, Fig. 2E) and self-
portrait as a skull (1968) all share a missing resemblance to the painter. This is substantially different from
the self-portraits Dix painted in 1957 (Fig. 2B), 1964 (Fig. 2C), and 1967 whose similitude is very close to the
photographs showing Dix at the respective dates (Fig. 2A). Part A–F # VG Bild-Kunst, Bonn, 2006.
respective dates (Fig. 2A). Self-portrait with black collar bears a

certain resemblance to Dix, but spatial relations and facial structures are disturb-
ing, with his closed right eye seemingly protruded (Fig. 2D). The painter’s face
appears to be held upon the left side of the portrait by a frame-like band,
seemingly preventing the painters head from falling forward. Small self-portrait
has much of a caricature (Fig. 2F), and self-portrait with a hand shows the
painter’s hand holding the pencil in the forefront of the drawing covering most
parts of the lower face (Fig. 2E). On this right hand, we count more than five
fingers; the same observation can be made with certitude in his last large self-
portrait with Marcella (1969) in which Dix holds the little girl with both hands.
At his right hand, six fingers can be diVerentiated. Dix continued to paint until
his death, working mostly on lithographs. He died of a second stroke on July 25,
1969 in Singen.
C. JOHANNES THIEL
Johannes Thiel (September 11, 1889–September 31, 1962) traveled in Europe

after studies at the academies of art in Munich and Stuttgart. He lived in Kirchzarten
near Freiburg, producing landscape and figure paintings as well as book illustrations.
His best artwork, according to Jung (1974), was his watercolor landscapes in which
Thiel reached perfection in the 6th and 7th decades of his life. Thiel suVered two
strokes with left-sided hemiparesis in 1959 (facial paresis on the left and mild
weakness of the left hand with complete recovery) and 1960 (with a permanent left
hand weakness) but recovered fairly well and was enormously productive until a
third stroke in 1962 put an end to his life. Except for a portrait sketch done in the
days following his first stroke, Jung was unable to notice any change in style or signs
of neglect. Jung examined Thiel after his third and subsequently fatal stroke and
described a left-sided hemiplegia and hemianopsia ( Jung, 1974).
D. LOVIS CORINTH
Lovis Corinth ( July 21, 1858–July 17, 1925) certainly has the most interesting
patient history of this case series (Chapter 14 by Blanke). This German painter
was one of the most important and innovative artists of the period and is
nowadays represented in the major museums and galleries of Europe and USA
(Schuster et al., 1996). After his study period at academies in Königsberg and
Paris, he lived in Munich for about 10 years. Then a ‘‘realistic naturalist,’’ he
moved to Berlin, where he settled down in 1901, to work as a painter and teacher
of arts. He founded the first women’s painting school of Berlin, and his first pupil,
Charlotte Berend, became his preferred model and his wife in 1902 (Uhr, 1990).
In Berlin, Corinth rapidly succeeded to become a leading member of the Berlin
‘‘Secession’’ with Liebermann and Slevogt to form the triad of German impres-
sionism. Besides his paintings of landscapes, portraits, nudes, and still-lives,
Corinth was dedicated to biblical, mythological, and literary subjects. Moreover,
he produced large quantities of drawings, lithographs, etchings, and watercolors.
Later, his style changed substantially, and he became a protagonist of expressive
(or expressionist) realism.
In November 1911, Corinth sustained a right hemisphere stroke with a left-
sided hemiparesis and hemineglect and a subsequent severe depressive episode.
After this, he limped when tired, his gait became shuZing, and his left hand no
longer obeyed when he tried to perform intricate tasks (Berend-Corinth, 1958a,
b). Later photographs show a spastic posture of his left arm and hand, but his wife
states that he used his weak left hand to press the copper plate to his body while
engraving (Schuster et al., 1996; Uhr, 1990). In the days immediately following
the stroke, Corinth describes dream-like optical sensations and states further that
he had come face-to-face with death (Corinth, 1923). According to Horst Uhr
(1990), ‘‘in one form or another virtually all his subsequent works bear the mark
of this experience.’’ Critics agree that Corinth’s works underwent a change of
style, but they are unanimous in attributing this change to purely psychological
factors such as depression and intensified awareness of the fragility of human life,
increasing preoccupation with death, and heightened capacity to seize the es-
sence of objects and experience. Alfred Kuhn, a contemporary critic who edited
an early Corinth monograph in 1925, interpreted his late works as follows,
‘‘When Corinth arose from the sickbed, he was a new person. He had become
prescient for the hidden facets of appearance . . .. The contours disappear, the
bodies are often as if ript asunder, deformed, disappeared into textures . . . also
the faithfulness of portraits had ceased almost entirely . . . all detailed execution
came to nothing. With wide stripes the person is captured in essence. Character-
isation is now exaggerated, indeed, often to caricature . . . models, no matter who
they are, are now just objects to be painted . . .. Indeed, the models must suVer
every deprivation. Corinth always seems to be painting a picture behind the
picture, one which he alone sees . . . at this point Corinth shifted from the ranks of
the great painters to the circle of great artists’’ (Kuhn, 1925).
Other than might be expected, Corinth’s productivity was even growing after
recovery. Close to 500 paintings, over 800 prints, and scores of watercolors and
drawings—more than half of all his works date from this period (Uhr, 1990).
However, he focuses on self-portraits, family portraits, and landscape and pro-
duces large series of lithographs and etchings, partly as illustrations to books. ‘‘My
entire life passed before me, a life which in this lonely battle seemed more
precious now than when I was young and strong. I was forced to reckon with
myself. [. . .] But time seemed so very short’’ (Corinth, 1926).
The first products after his stroke are very fascinating; while still on the
sickbed, Corinth asked for pencil and paper and sketched a series of horrible
monsters and strange ghost-like images of famous figures from history, apparent-
ly, none of these drawings has survived. When Charlotte accompanied him on
returning to his studio for the first time, she watched as he gazed long in the
familiar large mirror. In her diary-like memoirs, she writes ‘‘Again and again he
moaned in despair, black thoughts attacked him [. . .]. I had no more ideas to
console him. [. . .] Then suddenly, he reached for palette and paint, sat down and
quickly dashed oV this first of a long series of sorrowful self-portraits’’ (Berend-
Corinth, 1958b). In fact, this self-portrait shows the painter wearing a coat over
the pajama from his sickbed. The self-portraits following his stroke show a
continuous process of confrontation with his declining physical constitution and
were to focus on his physical frailty and mental anguish. In early February 1912,
using the ‘‘vernis-mou’’ technique he made a small engraving showing the sick
painter as ‘‘Job with his friends’’ (Fig. 3). His son, Thomas, remembered that
Hermann Struck, a friend of Corinth, assisted with the preparation of the
FIG. 3. Lovis Corinth’s self-portraits following his stroke show a continuous process of
confrontation with his declining physical constitution and were to focus on his physical frailty and
mental anguish. In early February 1912 he made a small engraving showing the sick painter as ‘‘Job
with his friends.’’ # Kupferstichkabinett. Staatliche Museen zu Berlin.
printing plate (Corinth, 1979). In the print, Job is depicted while sitting on the
floor with crossed legs, his right hand is placed on the right foot, the supinated
and palmarflexed lame and atrophic left arm is resting on the floor, his right foot
is supinated. Job is wearing a cape that Corinth had used in earlier self-portraits.
The title of the etching contains a small mistake in the mirrored text with a twist
of the character ‘‘&.’’
With Charlotte, he traveled to Bordighera on the Italian Riviera in spring 1912,
which was intended to serve as a kind of rehabilitation stay. There he completed a
small pencil self-portrait that hardly resembles the painter. Several similar studies at
this time show a left-sided neglect with missing parts of right upper extremities. A
pencil drawing of his wife also finished in Bordighera grossly lacks texture, her dress
looks lifeless; the lack of plausible anatomical articulation results in a strong sense of
compression, his wife appearing ill at ease (Schuster et al., 1996). In contrast, a very
appealing balcony scene in Bordighera shows his wife on the balcony of the hotel at
the moment she unfolds a small parasol. Following Horst Uhr, this painting lacks
correct perspective with the vertical lines of the hotel’s facade not matching and the
building appearing to lean to the left (Uhr, 1990). Later Bordighera paintings,
however, seem to reflect his ongoing recovery. The first large painting of 1912
shows ‘‘Samson blinded’’ as a martyred and desperate figure, grasping in the
direction of the observer, insecure, and not yet relying on his regained forces
(Uhr, 1990). In a preparatory pencil study for ‘‘Samson blinded,’’ the biblical figure
is grotesquely distorted (Schuster et al., 1996). Still in October 1912, 11 months after
the stroke, a small pencil study of his wife still shows a marked neglect with missing
contours of the left face (reproduced in Corinth’s autobiography in 1926). We agree
with Jung (1974), who finds the neglect compensated after 1913 in landscape
paintings but notices several occurrences of uncertainty in the reproduction of
left-sided facial aspects in his self-portraits. Here, the artist has to fixate strongly on
his face in a mirror. In doing so, a visual field defect focused in the parafoveal
region might become apparent. Interestingly and other than famous colleagues,
Corinth never corrected the mirror eVect in that, the right handed painter holds the
pencil in the left hand in all of his self-portraits (however, this can be noticed also
prior to his stroke!). (The detailed analysis of Corinth’s self-portraits is given in
Chapter 14 by Blanke in this volume.)
The sequelae of his stroke were reported by Corinth’s wife Charlotte, who
described her husband’s anxiety and depression and the exhaustion following the
slightest physical exertion (Berend-Corinth, 1958b). According to Uhr ‘‘she aided
him as he struggled to summon up his strength. She laid out the colours before
him, placed palette and brushes in his encumbered left hand, and removed them
from his stiV and swollen fingers when he had finished painting. When his own
hand failed to provide adequate support, she gently and tactfully helped to steady
his sketchbook’’ (Uhr, 1990). Remarkably, Charlotte writes in her memoirs on
several occasions of her husbands ‘‘first’’ stroke, although a definite description of
a second stroke is never given. On the occasion of his 60th birthday, Corinth had
a syncopal attack as far as can be gathered from his wife’s diary (Berend-Corinth,
1958b).
Certainly, the judgment of an art critic or art historian will be diVerent from
that of a neurologist familiar with the consequences of right hemisphere damage.
Of course, the artist reacts to the ‘‘stroke attack’’ with thematic changes and may
be obliged to paint stylistic variations. But as Gardner (1977) has pointed out, the
specific features altered in Corinth’s work are striking: loss of contours (e.g., in the
portrait of the painter Grönvold, 1925 or in ‘‘Frauenraub,’’ 1918), misplacement
of details (e.g., etching of ‘‘Knecht Franz,’’ 1919, with asymmetric arms), neglect
and obscuring of texture (e.g., in ‘‘Susanna and the Elders,’’ 1923 and ‘‘Birth of
Venus,’’ 1923), alteration of emotional nuance (e.g., portrait of his son Thomas
with a hat in his hands, 1922), increased subjectivity (e.g., in ‘‘Carmencita,’’ 1924,
compared with a prestroke painting of a similar subject, Woman with a black mask,
1908, Fig. 4), idiosyncrasy (e.g., in ‘‘Still Life with Flowers, Skull, and Oak Leaves,’’
1920), obscurity (in several Walchensee paintings of 1924 and 1925). Further, we
would add dissimilarity of familiar faces in portraits (e.g., in an engraving of his wife
in 1920, compared to a prestroke portrait of 1911, Fig. 5A and B), lack of correct
perspective (e.g., ‘‘On the Balcony in Bordighera,’’ 1912, ‘‘Berlin unter den
Linden,’’ 1922), and lack of anatomical exactitude (e.g., study for ‘‘Samson
FIG. 4. Lovis Corinth’s post-stroke paintings show a marked increase in subjectivity. A good example
for this feature is the painting ‘‘Carmencita’’ (1924, Fig. 4B, by courtesy of Städelsches Kunstinstitut,
Frankfurt am Main, Städelscher Museums-Vereine. V.), the last portrait of his wife Charlotte. In contrast, a
prestroke painting of a similar subject, ‘‘Woman with a black mask,’’ dating from 1908 (Fig. 4A, ‘‘Die
schwarze Maske’’, by courtesy of Staatliche Museen Kassel), is much more realistic.
FIG. 5. Corinth’s post-stroke portraits demonstrate a definite dissimilarity of familiar faces such as in
a pencil drawing of his wife in 1920 (Fig. 5B, Lovis Corinth, German, 1858–1925, Portrait of Charlotte
Berend-Corinth, 1920, graphite on ivory wove paper, 457 300 mm (max.), Gift of Dennis Adrian in
memory of Charlotte Berend-Corinth, 1968.20, The Art Institute of Chicago. Photography # The Art
Institute of Chicago. Detail) compared to a prestroke portrait of 1911 (Fig. 5A, # 2006 Museum
Associates/LACMA).
blinded,’’ 1912 and ‘‘Pieta,’’ 1920). These examples could be completed by a more
thorough analysis of Corinth’s total oeuvre, but to be fair, large parts of his late
work are simply superb products of a great artist and do not bear any ‘‘pathological
features,’’ either from the point of view of a critical neurologist and ambitious
pathographer. On the other hand, Corinth’s immense number of artwork allows a
detailed study of some very subtle consequences of his cerebrovascular disease.
E. WOLFGANG AICHINGER-KASSEK
Wolfgang Aichinger-Kassek is an Austrian artist, who suVered a right hemi-

sphere stroke on the basis of arterio-arterial embolism from a severe carotid
stenosis in 1995 (Aichinger-Kassek, 1995). When he recovered slowly from his
stroke, he noticed that he was unable to continue working on his sculptures that
he had constructed using heavy materials, cut from metal welded iron. As a
reaction to this drawback, he produced a series of ‘‘neurological folios’’ compris-
ing 30 colored graphics. His daughter, a consultant in neurology, writes in the
preface to this collection: ‘‘As soon as the acute stage of the apoplectic fit was
over, it gave way to thoughts regarding his future artistic career. They all ended
with the question of whether creative activity would still be possible. For many
long months, the phases of depression and despair seemed to hold the upper
hand and the paralysis of thought and inspiration outweighed all other problems.
The artist’s dependency on his ideas obliged [him] to assume the role of waiting
in uncertainty of his fate. But then, from one day to the next, feelings and
inspirations forced their way to the surface. It became possible to represent
pictorially the phases of depression, fear, of incursions into his own body, the
hospital environment. Most of the works in this cycle were created within a few
days (Fig. 6). The person W.A. now sees prospects for his future once again.’’
Aichinger-Kassek himself comments on his stroke as follows: ‘‘Apoplexy—that’s a
stroke of lightning in life’s thunderstorm! It attacks you! And fells you like a
blossoming tree. The stroke is the insidiousness of an unexpected menace. It’s
danger and warning. The stroken [sic!] one is defeated by a depressive attack
while his life is passing before his eyes like a trashy movie. Apoplexy—that’s also a
determination of life-positions consisting in bygone past and uncertain future.
In all, uncertainty is a serious component of insidiousness.’’
F. FEDERICO FELLINI
The case of the famous Italian film director and skilled painter and cartoonist
Federico Fellini (1920–1993) was reported extensively in 1998 by Cantagallo and
Della Sala (1998), who followed the artist for 2 months after a CT-documented
FIG. 6. Wolfgang Aichinger-Kassek, an Austrian artist suffered a right hemisphere stroke in 1995.
As a reaction, he produced a series of ‘‘neurological folios.’’ According to the artist’s daughter, they
represent ‘‘pictorially the phases of depression, fear, of incursions into his own body, the hospital
environment.’’ (Private collection).
right temporo-parietal ischemic stroke that left the artist with a severe sensorimo-
tor hemisyndrome and left inferior quadrantanopsia. Fellini was examined in
detail for his left visuomotor hemineglect syndrome, including neglect dyslexia as
well as some evidence of altered processing with neglected parts of the stimuli.
The artist was aware of his motor and attentional deficits but unable to function-
ally compensate for them. The documents of visuomotor neuropsychological
testing are reproduced in the paper and demonstrate besides the pure neuropsy-
chological deficit a remarkable introspective analysis of the artist’s own situation,
including some quite ironical and sometimes provocative though charming
personalized ruminations.
G. REYNOLD BROWN
Reynold Brown (1917–1991) received his first art education in Alhambra

High School in California. The following information was obtained through
the website designed and maintained by his son Franz (http://www.geocities.
com/chapulinas). He illustrated and drew a comic strip and produced illustra-
tions for service manuals, several magazines, and pocket books. In 1950s,
Brown decided to come back to freelance illustration and took a teaching

position at Art Center College of Design, where he taught figure and head
drawing for 26 years. At that time, he started a series of movie posters for the
large film companies and for record jacket covers. From 1970s, Brown concen-
trated on fine art painting, with western themes as his preferred subject, and
succeeded by selling about 250 oil paintings, including portraits, harbor scenes,
and landscapes.
In 1976, Brown suVered a severe stroke together with a myocardial infarction
leaving him with a severe left-sided hemiparesis and hemineglect syndrome.
Compared to his colleagues suVering from right hemisphere damage, Brown
was hit by the stroke in even more devastating manner, since the paralyzed
left arm was his ‘‘drawing arm,’’ and his doctors’ prognosis as to future artistic
work was pessimistic. His doctors were wrong; similar to Corinth and his wife
Charlotte, Brown was helped to retrain his physical abilities during his first
steps back into art by his wife Mary Louise, who was an artist as well. She was
working with him everyday so that he first started to draw and then paint
again. Emphasis was put into the eVort of teaching the ‘‘good’’ right arm. Brown
had to battle further a very dense left lower quadrantanopsia, which made
him tend to leave the lower left portion of the canvas unpainted; he started
each session on the right side of a painting, which resulted in canvasses heavily
worked on the right and thinly painted on the left. His portraits were disorga-
nized with a marked distortion of facial structures, similar to Corinth’s and
Räderscheidt’s (self ) portraits. Franz Brown comments on a stretching eVect
present from upper right to lower left, which decreased with time. The same
eVect can be seen in several of Corinth’s portraits and self-portraits and in
the series of Räderscheidt’s self-portraits. A further source of frustration was
the limited use of his previously dominant left hand, due to a severe reduction
of tactile sense. In summary, according to his son, he was subsequently unable to
do the highly representational work of his prestroke years but ‘‘was nonetheless
able to produce some powerful drawings and beautiful landscape paintings
of Nebraska,’’ where he settled in 1983 and remained until his death in 1991.
Franz Brown states that his portraits ‘‘for some [. . .] carry a greater emotional
impact than the more realistic work of his earlier years. His landscapes became
looser and more painterly,’’ and he ‘‘seemed to see the world on diVerent, more
intense colours.’’
The cited homepage (http://www.geocities.com/chapulinas) contains a se-
ries of most remarkable drawings and paintings by Brown, done in the period
after his right hemisphere stroke (Fig. 7). In a striking similarity to the early post-
stroke artwork by Lovis Corinth, Brown’s drawings show a severe left-sided
hemineglect, which improves through the following years but is never perfectly
resolved as far as can be assessed from the paintings exhibited.
FIG. 7. Reynold Brown’s drawings and paintings produced in the period after his right-
hemisphere stroke resemble strikingly to the early post-stroke artwork by Lovis Corinth and Anton
Räderscheidt. His drawings show a severe left sided hemineglect, which is improving through the
following years. Reproduced with permission of the Tejeda-Brown family.
H. TOM GREENSHIELDS
Tom Greenshields (1915–1994), an accomplished and well-known painter

and sculptor was 75 years old, when he had a right hemisphere stroke in August
1989 (Halligan and Marshall, 1997). His symptoms included a mild sensorimotor
hemisyndrome on the left side, left lower quadrantanopsia, and left visual neglect.
Eight years earlier, he had lost the use of his right painting arm in an accident.
Therefore, he had learned to transfer his artistic skills to the left hand and
continued to work as painter and sculptor and to sell and exhibit his artwork.
After his stroke, despite good physical recovery of his left arm and hand function,
he became frustrated because of poorly constructed and less elaborate drawings,
compared to his prestroke creations. He concentrated on the right side of his
drawings and sculptures and neglected the left parts; moreover, his artwork
showed distorted, exaggerated or deformed figures. On neuropsychological ex-
amination, visuospatial neglect was confirmed. Similar to Reynold Brown, he
would ignore food on the left side of the plate. A photograph of a sculpture in
Halligan’s paper (Fig. 1 bottom) shows a clay sculpture with intact facial propor-
tions on the right side of the face and very incomplete modeling of the left parts of
the face. Similar disturbances can be noticed in Fig. 2, a drawing of a sitting man
with missing left face, left shoulder, and left parts of the chair. According to
Halligan, residual traces of neglect were still discernible until the death of the
artist in 1994. This is the single case of a sculptor with a severe neglect described
so far reflecting the diYculty of the right hemisphere damaged individual to
detect and depict the third dimension.
I. SCHNIDER ET AL.
Schnider et al. (1993) described the case of an unnamed Swiss artist in 1993
who suVered a CT-documented large ischemic infarct in the right temporo-
parieto-occipital region. Post-stroke drawings diVered markedly from prestroke
ones with changes reflecting both behavioral and mood disturbances. This artist
exhibited hemispatial neglect, hallucinations, hyperverbalization (he would in-
clude much text in his early post-stroke sketches), and rapid cycles of a bipolar
disorder. His drawings became simplified, more sketch-like, although the techni-
cal characteristics seemed similar to the premorbid artwork. Remarkably, the
severity of neglect expressed in his drawings was highly variable and could
change within hours.
J. VIGOUROUX ET AL.
Vigouroux et al. (1990) published the case of an artist with right hemisphere
stroke in 1990. This unnamed ‘‘well-known French painter’’ exhibiting a large
variety of stroke risk factors, presented with a severe left-sided sensorimotor
hemisyndrome, including a severe left homonymous hemianopsia. Shortly after
the stroke, he experienced a severe depressive episode, apparently reflected in his
drawings that, according to the authors, were of minor quality at that point,
although particularly expressive at the same time. This period was followed by a
phase of rich pictorial production. Remarkably, these drawings and paintings
showed no alteration of figural shape or volume, no change in style, and
unchanged artistic topics compared to the premorbid period, in spite of a
variably severe hemineglect.
K. BLANKE ET AL.
Recently, Blanke et al. (2003) published the case of a 71-year-old artist with
mild left neglect as the consequence of a right parietal hemorrhage. Within her
post-stroke drawings, she used minimal color on the left, whereas she colored the
right side completely and evenly. Thus, she was able to produce the correct forms
of images in the left visual hemifield but not the colors.
L. GUGLIELMO LUSIGNOLI
Guglielmo Lusignoli (born in 1920) was aVected by a right hemisphere stroke

in 1987 at the zenith of his creativity and artistic production (Mazzucchi et al.,
1994). He suVered from hemineglect and left-sided paresis but resumed his work
and was enormously productive after the stroke.
M. KURT SCHWITTERS
As far as can be told from his biography (Orchard et al., 1998), the famous
German Dada artist Kurt Schwitters (1887–1948) suVered a right hemisphere
stroke in 1944 with subsequent paresis of his left arm. A second stroke (presum-
ably an hemorrhage) occurred in February 1946. In December 1945, he writes
‘‘I am [now] painting smaller formats and do some very small modelling, pocket
format. My sculptures are a new experience for me, they are my best works now.’’
Further evidence for any alterations in artistic expression is scarce.
III. Case Studies of Painters with Left Hemisphere Stroke
A. PAUL-ELIE GERNEZ
Paul-Elie Gernez (1888–1948) was recently identified by Boller (2005) as the

painter in Alajouanine’s seminal paper published in 1948 in Brain (Bonvicini,
1929). Gernez was a prominent member of the French contemporary school,
‘‘because of the originality of matter, technical qualities of realisation and intense
individualism of each of his works.’’ Many of his works can be seen in his home
town of Honfleur (Normandy) in the ‘‘Eugène Boudin’’ museum. When he was
only 23-years old, he obtained the post of ‘‘Professeur de dessin’’ at Honfleur high
school, and thanks to his art, he was able to become financially independent
shortly thereafter. He started with naturalistic paintings and drawings of still lives,
nudes, boats, and landscapes, experimented with pointillism and was inspired by
cubism toward 1920s. Alajouanine writes that his paintings create feelings of the
‘‘bitter and sensual poetry of Baudelaire’’ and the ‘‘delicious polyphonic music of
Debussy’’ (Bonvicini, 1929).
In 1940, when he was 52 years old, he was aVected by persistent aphasia after
two short and transient episodes. Alajouanine describes the aphasia as of Wer-
nicke type without any phonetic alteration or paresis but with a slight hemianopic
defect and accompanied by transient apraxia. Spoken language was disturbed
with anomia, severe paraphasia, and severe agraphia, comprehension was rela-
tively preserved as judged from normal conversation and intellect was not
altered. The painter was well aware of these deficits, saying that ‘‘there are in
me two men, the one who paints, who is normal while he is painting, and the
other one who is lost in the mist, who does not stick to life . . .. I am saying very
poorly what I mean . . .. There are inside me the one who grasps reality, life; there
is the other one who is lost as regards abstract thinking. When I am painting I am
outside my own life; my way of seeing things is even sharper than before; I find
everything again; I am a whole man. Even my right hand that seems strange to
me, I do not notice it when I am painting. These are two men, the one who is
grasped by reality to paint, the other one, the fool, who cannot manage words
anymore’’ (Bonvicini, 1929). Gernez became depressed and irritable and
‘‘increased the isolation to which he was prone.’’ According to Alajouanine, the
post-stroke artistic work was just as perfect as before, as he did not notice any
changes in his artistic skills or style, and his working speed was unchanged.
Connoisseurs believed that he had found even a more intense and acute expres-
sion, a view essentially shared by Boller (2005), who had been able to inspect pre-
and post-stroke paintings by Gernez with the help of his family. However, Boller
noticed a tendency to a more concrete and realistic style and a certain lack of the
‘‘almost oneiric poetry found in some of his previous paintings.’’
B. DANIEL URRABIETA Y VIERGE
Daniel Urrabieta y Vierge (March 5, 1851–May 2, 1904) was born in Madrid

to a noted illustrator. Vierge studied at the Madrid Academy and went to Paris at
the age of 16 to become a painter and is often referred to as one of the founders of
modern illustration. Due to the Franco–Prussian war he was obliged to interrupt
his studies and started a career in 1870 as an illustrator for leading Paris
magazines and several books, some by Victor Hugo. At the age of 25, he began
to prepare for a new kind of illustrated book choosing Quevedo’s ‘‘Pablo de
Segovia’’ as his subject. Using the new photo-engraving process for his illustra-
tions, he became known to a broader public when the first edition of this book
was published in 1882. However, after he had already finished 90 illustrations,
the work on the complete edition of this book had almost been finished, his
compellingly straight career was interrupted by a severe stroke on February 14,
1882, when he was just 30 years old (Alajouanine, 1948; Bonvicini, 1926).
Charcot, who had been called, thought that he was lost, but he survived and
recovered fairly well, although his right side was completely paralyzed and he
had lost his speech. His only verbal expression consisted of the recurring word
‘‘paciencia’’ (Spanish for patience), later of repeated syllables such as ‘‘de-de-de.’’
Furthermore, he had a severe agraphia, while comprehension seemed to be well
preserved. Over a period of 2 years, his right-sided paresis improved except for
his right hand and wrist, which remained weak. Bonvicini (1926) reported that he
was still able to roll a cigarette with his left hand on his right arm. The most
remarkable aspect was that Vierge learned to draw and paint with his left hand in
a period of 6 months. He was able to resume his previous work 2 years after the
stroke. Interestingly, Vierge made two engravings, displaying the electrotherapy

service at the Salpêtrière, which had been started by Vigouroux with the support
of Charcot (Holcomb, 1967). Electrotherapy was a popular method of treatment
for paralysis at that time, and Vierge must have hoped to get some improvement
for his severe paresis after the stroke.
While clearly less prolific as he had been, he completed the remaining 20
illustrations for ‘‘Pablo de Segovia,’’ which was published in the complete edition
in 1892. His major achievement, the 257 illustrations for his Don Quixote were
all done after his stroke using the left hand. This incredible eVort took him 10
years, before the four volume set was published in an edition of 1150 copies in
1906. Bonvicini comments on a certain change in artistic technical orientation
after the stroke with a growing devotion to watercolors and even oil paintings in a
realistic style (Bonvicini, 1926). Even though Bonvicini may be correct with
regard to technical orientation, the post-stroke paintings that were available to
us did not show any major stylistic change compared to the prestroke artwork.
Vierge died in 1904 of a second stroke at the age of 53.
C. ZLATYU BOIJADJIEV
A further case of left-hemisphere stroke in a professional artist is reported of the

Bulgarian painter Zlatyu Boijadjiev (October 22, 1903–February 2, 1976). This
famous protagonist of contemporary Bulgarian art suVered a left hemisphere
stroke, which, according to the 1969 paper by Zaimov and colleagues (Zaimov
et al., 1969), may well have been a cerebral hemorrhage. The onset of symptoms
was accompanied by a severe headache and a right oculomotor palsy. The artist
was severely confused and bedridden but was able to leave hospital for rehabilita-
tion at his home only 5 weeks later. Neurological examination showed a right-sided
hemiplegia and a mixed but predominantly expressive aphasia together with the
right oculomotor palsy. Only 5 months later, he was able to take a few steps and
learned to use a cane; at that time his oculomotor palsy resolved. Neurological
examination showed a residual spastic hemiparesis 2 years later, enabling him to
walk on his own but with no function in the right distal upper extremity. He had a
vocabulary of about 70–80 words and showed variable word comprehension,
together with agraphia and alexia. He later developed symptomatic epilepsy.
Regarding his artistic career, he had to learn painting and drawing with his
left hand, which he tried to do for the first time 3 months after the stroke. Slowly
his left hand drawings improved to the degree that enabled him to resume his
previous creative output, totaling more than 500 paintings in the post-stroke
era. The stylistic changes in these paintings are judged by critics as marking the
birth of a new painter, as he now preferred bright colors, and the narrative
and naturalistic character of his prestroke paintings were no longer present.
In contrast, his paintings became richer, more colorful, although more simplified,
similar to primitive art, demonstrating great vigor, and inventiveness. Much of
the imagery was bizarre and fantastical.
D. ERNST OLDENBURG
Ernst Oldenburg ( January 8, 1914–January 9, 1992), a locally well-known

German painter and sculptor, suVered a left hemisphere stroke at the age of
74 (1988) with a severe paresis of his dominant right arm (Pese and Ramas-
Oldenburg, 2004). The first sketch done after his stroke using his untrained left
hand shows a very insecure outlining with nonetheless excellent figural composi-
tion, although the figures are placed on the left part of the paper, indicating
certain neglect on the right. After being discharged from hospital, he resumed his
artistic production beginning with a self-portrait that resembles the painter very
much and bears no stylistic changes to previous self-portraits. Similar to a self-
portrait finished a year later, except for a certain blurring of the left half of his
glasses and the left eye, which cannot be diVerentiated from the surrounding
texture, no signs of stroke can be inferred. His figural compositions are definitely
unchanged to the prestroke paintings, so that we can state that Oldenburg as with
Vierge, managed to continue his professional artistry with no significant alter-
ation of painting style and only a mild right visuospatial neglect, despite being
forced to transfer his artistic abilities from the right to the left hand. According to
his daughter, he had no aphasic disturbance.
E. BENI FERENCZY
Kornyey reports the case of an artist (Kornyey, 1977) active in drawing and
water painting but most prominent in sculpture, later identified as the Hungarian
artist Beni Ferenczy ( June 18, 1890–June 2, 1967) (Marsh and Philwin, 1987), who
suVered a left hemisphere stroke at the age of 66 years. Right hemiparesis and
severe motor aphasia remained persistent in spite of modest progress in his writing
performance. Some months after the insult, he resumed his artistic activity using
the left hand and continued principally in the same manner as during his prestroke
artistic career. His drawing and water painting were basically unchanged apart
from some uncertainty of lines and a certain loss of perspective. His pieces of
sculpture regained the quality of his earlier works, as proven by the first statue he
made after the stroke. This is the single instance of a sculptor with left hemisphere
stroke proving essentially unchanged three-dimensional perception and artistic
output and contrasts nicely with the case of Tom Greenshields, who was no longer
able to return to perfect sculptural production after a right hemisphere stroke.
F. POLISH PAINTER ‘‘R. L.’’
Kaczmarek described the case of the Polish painter ‘‘R. L.’’ (Kaczmarek,
1991), who was an Associate Professor at the Faculty of Arts, the University of
Lublin. R. L. may be the clearest example of an artist with a change in style due
to an aphasic disturbance after stroke (Chatterjee, 2004). R. L. suVered a left
hemisphere stroke with expressive aphasia. After the stroke, the production of
skilled charcoal drawings, easily recognizable self-portraits, and landscapes were
still possible, but the painter complained of the loss of his previous ability to paint
highly symbolic paintings after his stroke. He was aware of the deficit and said
that his mind was blank and he could not return to his premorbid style of
symbolic painting. This case uniquely illustrates the need of verbal ‘‘symbolic’’
processing for visual ‘‘symbolic’’ output.
G. AFRO BASALDELLA
The Italian neurologist Anna Mazzucchi has collected a series of Italian and
European painters (Mazzucchi et al., 1994) who had suVered a stroke. Among
them, Afro Basaldella (March 4, 1912–July 24, 1976) had a left hemisphere stroke
accompanied by profound aphasia in 1971. He reportedly returned to ‘‘neo-
cubism’’ 2 years after his stroke.
H. ARNOLD BÖCKLIN
Arnold Böcklin (October 16, 1827–January 16, 1901) had first stroke aVect-
ing his right side of the body in 1892. In an early biography from 1907, von
Ostini (1907) comments on a strange case of a very annoying illness that was at its
beginning not clear to the doctors, but the use of baths at the seashore brought a
sudden recovery; he repeatedly went to San Terenzo near La Spezia. From
autumn 1893 until spring 1895, he stayed in Florence with a scarcely restored
constitution. The biographer described the paintings Böcklin created at that time
by commenting on the growing variety and diVerentiation in the use of colors.
The two main final oeuvres were ‘‘The War (1897)’’ and the unfinished ‘‘The
Plague (1898).’’ Both are horrifying depictions of the themes with an apocalyptic
visionary character. In April 1895, Böcklin settled down in a house near Fiesole.
Von Ostini states that from his 70th birthday onwards, the ailments of impeding
age brought his artistic production to an end. According to the biographer, his
speech and gait were disabled through repeated strokes, and on January 16, 1901
Böcklin died after a brief final illness. In summary, the right-sided paresis and
speech disturbance of Böcklin may be interpreted as due to repeated left
hemisphere strokes, possibly on the basis of recurrent embolism from a left

carotid stenosis. Alternatively, one may speculate about repeated minor (lacunar)
strokes, as there was only minimal evidence for a true aphasic disturbance.
I. CASPAR DAVID FRIEDRICH
Caspar David Friedrich (September 5, 1774–May 7, 1840), a well-known

German painter of realistic landscapes, suVered a left hemisphere stroke in his
61st year of life (Hinz, 1974; Jensen, 1974), which caused a right-sided hemipar-
esis. A long stay in Teplice, where he used the warm baths shortly after the onset
of symptoms, allowed a fair recovery and enabled the painter to resume his
profession. However, he was no longer able to produce large paintings but
finished some smaller drawings often displaying desperate scenes such as ‘‘Land-
scape with Grave, CoYn, and Owl (1836/1837).’’ In a letter to his nephew dated
September 1835, Friedrich writes: ‘‘In Teplice, I stayed for six weeks on the
advice of my doctor, due to the known reason. Since the day before yesterday,
I am back at home. I am fairly well and back on my feet, and hope that the eVects
of the baths will continue to work, and will finally enable my hand to do some
work. [. . .] Writing goes as bad as thinking today . . .’’ (Hinz, 1974). On Novem-
ber 19: ‘‘Sincerely, I have not the hope that I will fully recover from the paresis.’’
On December 12: ‘‘I have had so many visitors recently that due to my sick legs
and the unfamiliar tongue, I felt so much under pressure that for nobody could I
be the person; I would have liked to be.’’ This is the single occasion of a possible
speech involvement in Friedrich’s stroke. On March 19, 1840, Shukowski noted
in his diary after a visit to Friedrich: ‘‘Been visiting Friedrich. Sad ruin. He cried
like a child’’ ( Jensen, 1974). Friedrich’s friend, Carl Gustav Carus, a doctor and
painter, wrote about Friedrich: ‘‘Possibly as precedents of a developing brain
disease Friedrich died of later, and along with his strange, always dark and often
rude character, he had developed certain fixed ideas which began to undermine
his existence at home: suspicious as he was, he martyred himself and his family
with the idea of his wife being unfaithful, which was completely absurd, but was
severe enough to absorb him completely from his family.’’ Kerner (1974) attrib-
uted his cerebrovascular insult to neurosyphillis, a diagnosis that he deduces from
a self-portrait showing unequal pupils. Indeed, Friedrich’s self-portrait dating
from 1810 shows a larger pupil on the left. But another evidence for this diagnosis
is scarce, given the few hints to a severe chronic neurological illness until the
stroke. Friedrich certainly experienced recurrent episodes of depression reflected
in several reproductions of cemeteries or similar subjects.
Similar to Böcklin, a definite diagnosis in Friedrich’s case is not possible.
Both left hemisphere strokes due to repeated embolism and, more plausibly, a
lacunar syndrome with the subsequent development of subcortical vascular
encephalopathy (including gait disturbance, depression, cognitive decline, and

dysarthria) are possible explanations.
IV. Other Cases
A. THE CASE OF AN 87-YEAR-OLD ARTIST
Smith and colleagues (2003) report the case of an 87-year-old artist who experi-
enced a top-of-the-basilar-artery embolic stroke with subsequent visual agnosia. She
had painted scenes solely from her memory prior to her stroke. During recovery
from stroke, her serial drawings and paintings revealed selective attention to the left
lower quadrant, ‘‘with important aspects of the whole image ‘clipped’ as if missing
from her internal representation of the whole object.’’ She made a good recovery
over the following years with only minor diVerences in her artistic products from
those prior to stroke. The authors interpret her problem as simultanagnosia—the
inability to simultaneously process visual parts and synthesize meaning. Lesions able
to produce such a disturbance may be uni- or bilateral in the posterior parietal lobes.
B. TOMMY MCHUGH
Recently, the remarkable case of Tommy McHugh (born in 1950) was

reported by Lythgoe et al. (2005). This gentleman, who reported his personality
as fiery temper and aggressive, suVered a subarachnoid hemorrhage from bilat-
eral middle cerebral artery aneurysms. Subsequently, he experienced a depressive
episode and complained of a ‘‘split-mind disorder.’’ Strikingly, after recovery
from brain damage and depression, the former builder, who had never been
active as an artist before, started to feel an insatiable need to create, from painting
and drawing to writing and sculpting. His first drawings during recovery showed
signs of a left hemispatial neglect. During early recovery, he began to compose
poems and verse, describing his ‘‘split brain’’ altered perceptions and personality.
Later, he started to draw large quantities of sketches, mainly of faces, all of them
asymmetric, followed by large-scale drawings on the walls of his house. He
claimed that the brain injury left him obsessed with making art, and he now
spends most of his day painting and sculpting.
C. JON SARKIN
Comparably, the case of former chiropractor Jon Sarkin (born in April 27,
1953) provoked astonishment (Winner and von Karolyi, 1998). Sarkin was
operated by a well-known vascular neurosurgeon with the intention to cure his

tinnitus and vertigo, which was thought to be caused by a vascular compression
of his left 8th cranial nerve. Apparently, a severe postsurgery hemorrhage led to a
coma and necessitated an immediate craniotomy and removal of the hematoma
and partial resection of his cerebellum. Sarkin recovered very slowly. When he
was back at home, he was a diVerent person. He was now disorganized and
chaotic, manic in energy, driven to philosophical ramblings and strange poetry,
and intricate, humorous paintings. He became obsessed with color and declared
that he could really see color. He had a very powerful urge to paint that he could
not resist. His story was sold to a large Hollywood company in order to produce a
film with the famous actor Tom Cruise depicting Sarkin.
V. Conclusions
This series of 25 visual arts professionals (13 right hemisphere strokes, 9 left
hemisphere strokes, and 3 other) illustrates the large variability of the conse-
quences of stroke for their artistic creation. This series of painters had a mean age
of 63 at stroke onset and survived their first stroke for more than 8 years (Table I).
a. Not surprisingly, the immediate reaction after a devastating and unexpect-
ed stroke ‘‘attack’’ is very often a period of depression and despair. Irrespective of
the lesioned hemisphere, both left- and right-sided strokes lead sometimes to very
severe episodes of depression and even to suicidal attempts. Valuable introspec-
tive comments on their disease can be found in Corinth’s, Aichinger-Kassek’s,
and Tommy McHugh’s reports.
b. Stroke influences paintings of the vast majority of artists to a significant
degree. Whereas in some cases the (repeated) strokes ended artistic careers
(Friedrich, Fellini), the majority reported resumed artistic production, although
having to overcome various types and degrees of disability.
c. Four of the artists suVering a left hemisphere stroke had to switch
from their prestroke dominant right hand to the left hand (Vierge, Boiyadjiev,
Oldenburg, case Kornyey), which was possible without a notable change in style,
except for Boiyadjiev. Vice versa, Reynold Brown, a previously left-handed
artist suVered a right hemisphere stroke and had to learn to use his previously
nondominant right hand. His artwork was further altered by severe visual
disturbances.
d. Visuospatial neglect is far more common in right hemisphere stroke than
in left hemisphere damage. Noticeable degrees of neglect can be deferred from
the post-stroke artwork of virtually all of the right-hemisphere patient—artists.
This severe problem for the visual artist is often compensated in paintings of the
TABLE I
THE SERIES OF 25 VISUAL ARTS PROFESSIONALS ILLUSTRATES THE LARGE VARIABILITY OF THE CONSEQUENCES OF STROKE FOR THEIR ARTISTIC CREATION
Date Date Date of Age at Years Influence

Author Last name First name of birth of death 1st stroke 1st stroke Hemisphere survived on painting
Lythgoe, 2005 McHugh Tommy 1950 Alive 2001 51 Bilateral 4 Definite

N.N. Sarkin Jon 1953 Alive 1989 46 Cerebellar 16 Definite
Kerner, 1974 Friedrich Caspar David 1774 1840 1835 June 26 61 Left 5 Definite
N.N. Böcklin Arnold 1827 1901 1892 May 14 65 Left 9 Uncertain
Bonvicini, 1926 Vierge Daniel 1851 1904 1882 Feb 14 30 Left 22 Definite
Alajouanine, 1948 Gernez Paul-Elie 1888 1948 1940 52 Left 8 Uncertain
Kornyey, 1977 Ferenczy Beni 1890 1967 1956 66 Left 11 Little
Zaimov, 1969 Boiyadjiev Zlatyu 1903 1976 1951 Nov 8 48 Left 25 Definite
Mazzucchi, 1994 Basaldella Afro 1912 1976 1971 59 Left 5 Definite
N.N. Oldenburg Ernst 1914 1992 1988 78 Left 4 Definite
188
Kaczmarek, 1991 L. R. Unknown Unknown 1991 Unknown Left Unknown Definite

Mazzucchi, 1994 Lusignoli Guglielmo 1920 Unknown 1987 67 Right Unknown Definite
Jung, 1974 Corinth Lovis 1858 1925 1911 Dec 53 Right 14 Definite
N.N. Schwitters Kurt 1887 1948 1944 57 Right 4 Uncertain
Jung, 1974 Thiel Johannes 1889 1962 1959 70 Right 3 Definite
Jung, 1974 Dix Otto 1891 1969 1967 Nov 13 76 Right 1,5 Definite
Jung, 1974 Räderscheidt Anton 1892 1970 1967 Sep 24 75 Right 2,5 Definite
Vigouroux, 1990 NN NN 1906 1985 1973 Apr 15 66 Right 12 Definite
Franz Brown (www) Brown Reynold 1917 1991 1976 59 Right 15 Definite
N.N. Aichinger-Kassek Wolfgang 1932 Alive 1995 64 Right Unknown Definite
Halligan, 1997 Greenshields Tom 1915 1994 1989 August 74 Right 5 Definite
Cantagallo, 1998 Fellini Federico 1920 1993 1993 73 Right 0,2 Definite
Blanke, 2003 N.N. N.N. 1932 Unknown 2003 71 Right Unknown Definite
Schnider, 1993 N.N. N.N. 1936 Unknown 1990 54 Right Unknown Definite
Smith, 2003 N.N. N.N. 1915 Unknown 2002 87 Right or Unknown Definite
bilateral
n ¼ 25 Mean: 62,7 9l, 13r, Mean: 8,7 Definite:
3 other n ¼ 21
wider scenery of landscapes and large figural compositions but is commonly

detectable in self-portraits due to the necessity of strong fixation in the center
of the visual field. Ernst Oldenburg is the only left hemisphere stroke victim, who
exhibited a mild neglect in his post-stroke self-portraits.
e. The finding of facial distortion in at least six of the right hemisphere
patients is hinting to the representation of both facial recognition and spatial
organization in the right hemisphere. In addition, the striking loss of self resem-
blance in the self-portraits of Corinth, Dix, and Räderscheidt points to a certain
degree of prosopagnosia in these right hemisphere stroke victims. Facial construc-
tion is unaVected in all of the painters with left hemisphere stroke. The case of
Tommy McHugh with hemispatial neglect to the left and asymmetrical portraits
produced after subarachnoid hemorrhage and surgical repair of bilateral middle
cerebral artery aneurysms suggest a predominantly right hemisphere damage.
f. Spatial organization is disturbed in several of the right hemisphere painters
with disturbances of perspective or of third dimension in sculptural creation. In
the post-stroke artwork by Corinth, Räderscheidt, Dix, Greenshields, and Brown,
anatomical exactitude is altered, details are misplaced. This is not the case in
painters with left hemisphere strokes.
g. The remarkable case of Lovis Corinth illustrates further possible conse-
quences of right hemisphere function to the artist: loss of contours, alteration of
emotional nuance, increased subjectivity, idiosyncrasy, and obscurity.
h. Hallucinatory episodes, delusions, and dream-like optical sensations can
be found in the case histories of several of the right hemisphere stroke painters
such as Räderscheidt, Corinth, Aichinger-Kassek, and Schnider’s case. The cases
of left hemisphere stroke victims, such as Friedrich and Böcklin, show a predom-
inance of symbols of death in their artistic realizations.
i. Evidence for a direct impact of aphasia on artistic production is scarce in
the reported cases, indicating that verbal and visual creative output may use
separate output channels. The case of a Polish painter who lost his previous
ability to paint highly symbolic paintings after left hemisphere stroke is unique in
that it illustrates the need of verbal ‘‘symbolic’’ processing for visual ‘‘symbolic’’
output.
j. Finally, as evidenced in the cases of Tommy McHugh and Jon Sarkin,
stroke damage has apparently the potential to unmask artistic potential.
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STROKE IN PAINTERS

H. Bäzner and M. Hennerici

A stroke may befall anyone because brain lesions caused by cerebrovascular

INTERNATIONAL REVIEW OF 165 Copyright 2006, Elsevier Inc.

neuroimaging technology have led to precise lesion localization, giving a better

II. Case Studies of Painters with Right Hemisphere Stroke

Anton Räderscheidt (October 11, 1892–March 3, 1970) started his artistic

mild left hemisyndrome. He had a left homonymous hemianopsia with left-sided

respective dates (Fig. 2A). Self-portrait with black collar bears a

Johannes Thiel (September 11, 1889–September 31, 1962) traveled in Europe

Wolfgang Aichinger-Kassek is an Austrian artist, who suVered a right hemi-

Reynold Brown (1917–1991) received his first art education in Alhambra

Brown decided to come back to freelance illustration and took a teaching

Tom Greenshields (1915–1994), an accomplished and well-known painter

Guglielmo Lusignoli (born in 1920) was aVected by a right hemisphere stroke

III. Case Studies of Painters with Left Hemisphere Stroke

Paul-Elie Gernez (1888–1948) was recently identified by Boller (2005) as the

B. DANIEL URRABIETA Y VIERGE

Daniel Urrabieta y Vierge (March 5, 1851–May 2, 1904) was born in Madrid

stroke. Interestingly, Vierge made two engravings, displaying the electrotherapy

A further case of left-hemisphere stroke in a professional artist is reported of the

Ernst Oldenburg ( January 8, 1914–January 9, 1992), a locally well-known

F. POLISH PAINTER ‘‘R. L.’’

hemisphere strokes, possibly on the basis of recurrent embolism from a left

I. CASPAR DAVID FRIEDRICH

Caspar David Friedrich (September 5, 1774–May 7, 1840), a well-known

encephalopathy (including gait disturbance, depression, cognitive decline, and

IV. Other Cases

A. THE CASE OF AN 87-YEAR-OLD ARTIST

Recently, the remarkable case of Tommy McHugh (born in 1950) was

operated by a well-known vascular neurosurgeon with the intention to cure his

Date Date Date of Age at Years Influence

Lythgoe, 2005 McHugh Tommy 1950 Alive 2001 51 Bilateral 4 Definite

Kaczmarek, 1991 L. R. Unknown Unknown 1991 Unknown Left Unknown Definite

wider scenery of landscapes and large figural compositions but is commonly

Aichinger-Kassek, W. (1995). ‘‘Neurological Folios.’’ Gorenjski Tisk, Kranj, Slovenia.

Berend-Corinth, C. (1958b). ‘‘Mein Leben mit Lovis Corinth.’’ München.

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