ABSTRACT
The clinical practice guideline for the stroke rehabilitation was formulated through both extensive review of published literature and consensus meeting of the specialists. The purposes of this study were to provide optimum practical guideline for acute and subacute stroke rehabilitation and to enhance the quality of stroke rehabilitation team in Korea. This guideline contains evidences and recommendations on the organization of post-stroke rehabilitation team, timing, evaluation, and intensity of rehabilitation, detailed management of dysphagia, neurogenic bladder and bowel, movement, shoulder problem, cognition, neglect, language, mood and complications commonly encountered in the acute and subacute period of stroke rehabilitation. Clinicians who are working in the field of stroke rehabilitation can adopt this guideline for their practice and give the feedback for further revision.
ABSTRACT
Acetazolamide, a selective-inhibitor of carbonic anhydrase. Has been shown to induce a rapid increase in cerebral blood flow by acidifying cerebral extracellular tluid in large doses. In order to assess the cerebral blood flow reserve, we investigated 14 patients with ischemic cerebrovascular disease using Tc-99m HMPAO SPECT before and after administration of acetazolamide.The patients after acetazolamide challenge showed variable pattems of vasodilating capacity which were classified as follows: group I. Accentuation of abnormal perfusion pattem; group II, no change in abnormal perfusion pattern: and group III. Blunting of abnormal perfusion pattern. Thirty-six percent of the patients studied qualified for group I. The p?tients in group I seem to have decreased vasodilating reserve in the area of cerebral ischemia. They are most likely to benefit by medical or surgical efforts to augment CBF delivery. Tc-99m HMPAO-SPECT with acetazolamide flow challenge may serve as an objective. Clinically accessible method for assessing blood flow reserve and as a kind of guide for the therapeutic strategy.