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KMID : 0603920070150020067
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Journal of Korean Academy of Occupational Therapy
2007 Volume.15 No. 2 p.67 ~ p.77
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Clinical Features and Lesion Analysis in Acute Stroke Patients with Contraversive Pusher Syndrome
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Kwon Yong-Hyun
Lee Mi-Young
Kim Kyung
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Abstract
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Objective : Stroke patients with contraversive pusher syndrome display a particular postural control while sitting and standing, and have a tendency to push away from the nonaffected side toward the affected side of their body. This intriguing symptom has a negative impact on recovery process and the functional activities of daily life. Therefore, we have attempted to investigate the possible causes that may elicit contraversive pusher syndrome.
Methods : We selected seventeen stroke patients with contraversive pusher syndrome. Clinical features were evaluated, such as Motricity Index, sensory test, unilateral neglect, and demographic data. Also, lesion volume was calculated on T1-weighed and T2 weighted MRI images using the Picture Archived Communication System. Lesion location was mapped on a templete MRI scans from the Montreal Neurological Institute though an analysis of lesion overlap using MRIcro software.
Results : There was statistically no difference in the severity of pusher behavior according to the presence of unilateral neglect symptom and the side of damaged hemispheres(p>.05). In correlation analysis, the scores of the scale for contraversive pushing were significantly correlated to sensory function, but not correlated to aging, Motricity Index, and lesion volume. Also, a lesion overlap analysis showed that most patients commonly had damaged areas in their internal capsule, corona radiata, or arcuate fasciculus.
Conclusion : The severity of contraversive pusher syndrome had a significant correlation with sensory dysfunction, but not on muscle strength, unilateral neglect, side of the damaged hemisphere, lesion size, or location. Also, damage of the internal capsule, coronal radiata and arcuate fasciculus seems to affect the motor control of upright body postures.
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KEYWORD
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Contraversive Pusher Syndrome, Lesion Volume and Location, Sensory Dysfunction
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