| Characteristics and Prognosis of Pusher Syndrome in Stroke Patients. |
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Lee, Jong Hwa , Kim, Sang Beom , Lee, Kyeong Woo , Kim, Byung Hee , Kim, Min Ah , Lee, Geon Cheol |
1Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine and Regional CardioCerebroVascular Center, Dong-A University Hospital, Korea. higpf@naver.com
2Department of Physical Theraphy, Kyungnam College University of Information & Technology, Korea. |
| 뇌졸중 환자에서 Pusher Syndrome의 특성과 예후 |
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이종화, 김상범, 이경우, 김병희, 김민아, 이건철1 |
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동아대학교 의과대학 재활의학교실 및 동아대학교병원 권역심뇌혈관질환센터, 1KIT 경남정보대학 물리치료과 |
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| Abstract |
Objective
To evaluate the incidence, associated neuropsychological symptoms, imaging feature and prognosis of pusher syndrome (PS).
Method
One hundred-ninety-seven patients with unilateral acute stroke were enrolled. Patients were evaluated for the presence and severity of PS using a standardized scale for contraversive pushing, neurological examination, assessment of neuropsychological symptoms (neglect, anosognosia, aphasia, apraxia), activities of daily living (ADL) and neuroimaging studies (CT or MRI). ADL was measured with Korean version of modified Barthel index (K-MBI).
Results
PS was found in 10.7% (n=21) of the included patients. No significant differences were found between patients with and without PS in age, sex, handedness, initial K-MBI score, neuropsychologic symptoms, lesion size and cortical involvement. Thalamic lesion was strongly correlated with PS (p＜0.05). PS had no independent influence on gain in ADL, but spent 4.8±1.7 weeks (p＜0.05) more to reach the same final outcome level than did patients without PS. Average symptom duration of PS was 14.6±3.6 weeks. Initial severity of PS did not influence on gain in ADL and recovery period.
Conclusion
PS did not affect final functional outcome, but slowed the process of recovery considerably. And thalamus seems to be fundamentally involved in control of upright body posture. Presence of PS is more important than severity of initial PS for prognosis. (J Korean Acad Rehab Med 2010; 34: 409-416) |
| Key Words:
Pusher syndrome, Stroke, Characteristics, Prognosis |
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