Pushing behavior and hemiparesis: which is critical for functional recovery in pusher patients?: case report
Arq. neuropsiquiatr
; Arq. neuropsiquiatr;65(2b): 536-539, jun. 2007. ilus
Article
in En
| LILACS
| ID: lil-456869
Responsible library:
BR1.1
ABSTRACT
We report a sequential neuroimaging study in a 48-years-old man with a history of chronic hypertension and lacunar strokes involving the ventral lateral posterior nucleus of the thalamus. The patient developed mild hemiparesis and severe contraversive pushing behavior after an acute hemorrhage affecting the right thalamus. Following standard motor physiotherapy, the pusher behavior completely resolved 3 months after the onset and, at that time, he had a Barthel Index of 85, although mild left hemiparesis was still present. This case report illustrates that pushing behavior itself may be severely incapacitating, may occur with only mild hemiparesis and affected patients may have dramatic functional improvement (Barthel Index 0 to 85) after resolution pushing behavior without recovery of hemiparesis.
RESUMO
Relatamos o estudo de neuroimagem seqüencial de um homem de 48 anos com história de hipertensão arterial crônica e acidentes vasculares cerebrais (AVCs) lacunares nos núcleos ventral lateral posterior do tálamo. O paciente desenvolveu hemiparesia leve e síndrome do empurrador (SE) grave após AVC hemorrágico no tálamo direito, sendo tratado com fisioterapia motora convencional. Três meses após o ictus, os sinais da síndrome haviam desaparecido e o paciente apresentava índice de Barthel 85, apesar da permanência da hemiparesia leve. Este caso demonstra que a síndrome do empurrador isolada pode ser gravemente incapacitante, pode ocorrer associada a hemiparesia leve e que os pacientes com esta síndrome podem apresentar recuperação funcional importante (índice de Barthel inicial 0 e final 85) após a resolução da SP sem alteração do grau de hemiparesia.
Full text:
1
Index:
LILACS
Main subject:
Paresis
/
Recovery of Function
/
Stroke
/
Movement Disorders
Type of study:
Etiology_studies
Limits:
Female
/
Humans
/
Male
Language:
En
Journal:
Arq Neuropsiquiatr
/
Arq. neuropsiquiatr
/
Arq. neuropsiquiatr. (Online)
/
Arquivos de neuro-psiquiatria (Impresso)
Journal subject:
NEUROLOGIA
/
PSIQUIATRIA
Year:
2007
Type:
Article