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Few methods have been validated for treatment of the painful hemiplegic shoulder. Harness slings and other methods of support have traditionally been applied in an attempt to prevent pain and subluxation, but supports often lead to complications. This paper describes shoulder taping in a patient with right hemiplegia following a cerebrovascular accident and evaluates taping efficacy through measures of activities of daily living, range of motion, and pain before, during, and after treatment. Taping significantly reduced pain and relieved excessive tension on the involved structures. The positive outcome obtained in this patient, in conjunction with other case reports, suggests shoulder taping may be more useful than traditional immobilization methods in the treatment of hemiplegic shoulders.

Introduction Diffuse intrinsic pontine glioma (DIPG) is a leading cause of brain tumor-related death in children. Prognosis is grim; with median survival less than one year. Current therapies are effective for a small period of time but not curative. Here, we discuss two patients with DIPG that presented concurrently to our institution in 2015. Case Report 1 A 10 yo healthy boy presented with intermittent left eye esotropia and diplopia. MRI findings were consistent with DIPG. Over two weeks, he developed right hemiplegia and multiple cranial nerve palsies. Upon …

A patient with endometrial cancer presented with intracranial hemorrhage from an undiagnosed metastatic brain tumor during abdominal radical hysterectomy. Since she was neurologically intact, a systematic examination for brain metastasis had not been performed preoperatively. After the surgery, she had delayed recovery from general anesthesia with right hemiplegia and aphasia. Computed tomography and magnetic resonance imaging showed left putaminal hemorrhage from brain metastasis.

Objective: We describe here a patient with intracerebral haemorrhage who showed recovery of an injured medial lemniscus and its related thalamocortical pathway on followup diffusion tensor tractography. Case report: A 48-year-old man presented with right hemiplegia following a spontaneous intracerebral haemorrhage in the left corona radiata and basal ganglia. He underwent conservative management for intracerebral haemorrhage and comprehensive rehabilitative therapy. Results: The kinesthetic sensation score (maximum score 24 points) of the Nottingham Sensory Assessment improved from 6 points (at 2 weeks after injury) to 10 points (at 6 weeks) and to 18 points (at 12 weeks). For the left thalamocortical pathway, a discontinuation at the left midbrain below the haematoma was observed on the 2-week diffusion tensor tractography. The 6-week diffusion tensor tractography showed that the integrity of the left thalamocortical pathway had been restored to the left primary motor cortex, and the 12-week diffusion tensor tractography showed restoration to the left primary somatosensory cortex. The fibre number of the left thalamocortical pathway showed an increase (470 at 2 weeks after injury, 1,080 at 6 weeks, and 1,626 at 12 weeks). Conclusion: This patient underwent recovery of an injured thalamocortical pathway over a period of 10 weeks after the second week following intracerebral haemorrhage, in terms of restoration of discontinued integrity and increased fibre number in the thalamocortical pathway.

Each student presents a unique challenge to a Yoga teacher. By approaching our students as individuals—taking the time to get to know them, understanding their physical and psychological needs, and acknowledging what they hope to gain from the practice—we can meet the challenge of communicating Yoga in a meaningful and accessible way. Ultimately, each of our students will offer us the opportunity to redefine our own interpretations of the practice and dig a little deeper for new ways of doing things. This article recalls my own such experience teaching a seventy-three year-old Yoga student recovering from a severe left-hemispheric stroke and learning to cope with"right hemiplegia."

Since malignant melanoma is a rare malignancy in Japan, little is known about the cytogenetic abnormalities in Japanese patients. We report a case of malignant melanoma showing complex chromosomal abnormalities. A 70-year-old woman was admitted to our hospital because of anorexia, delirium, and right hemiplegia. Cranial CT disclosed several metastatic brain tumors. Multiple subcutaneous and intra-abdominal metastases were also found. A diagnosis of metastatic malignant melanoma was made by biopsy of a subcutaneous tumor. Chromosomal analysis of the tumor cells disclosed complex karyotypic abnormalities including novel unbalanced whole arm translocations der (8; 14) (q10; q10) and der (11; 15) (q10; q10).

The purpose of this study was to investigate the hypothesis that EEG values match other comprehensive activities of daily living (ADL) evaluations between stroke survivors and normal controls. Various functions related to ADL were examined by means of ADL assessments (Measurement of Competence in the Elderly Living at Home, Barthel Index, Stroke Impairment Assessment Set, time needed to walk 10 metres) and biosocial synchronization (the questionnaire on biosocial rhythms of daily living). EEG was undertaken using a computer-assisted portable EEG recorder. The power spectra were computed using a fast Fourier transformation analysis (FFT). The absolute and relative powers (percent of the total EEG power) of 5 frequency bands (delta, theta, alpha 1, alpha 2 and beta) and the peak frequency were analyzed. In comparing stroke survivors and the independent elderly, the latter had higher scores than the former in assessments of various functions related to ADL. The absolute and relative power of the delta band were lower in normal controls, and the relative power of the alpha (2) band and the peak frequency were higher than those of stroke survivors. Among the correlations between EEG and ADL assessments, the absolute and relative power of the alpha (2) band correlated significantly with ADL assessments of stroke survivors with right hemiplegia. The peak frequency was significantly increased in cases with high ADL scores. In conclusion, significant correlations were identified between the quantitative EEG data of stroke survivors in the chronic stage, living in the community, and ADL-related functions. Computer-assisted portable EEG recording is a potentially useful screening tool for objectively evaluating the functional levels of stroke survivors in field work.

Fifty-one children with congenital hemiplegia (6–16 years) were included in this study, 28 with right hemiplegia (14 male and 14 female) and 23 with left hemiplegia (15 male and 8 female) as well as a control group (15 male and 15 female) chosen to match the subjects on age at testing, full scale IQ and socioeconomic status. A neurological examination, parent questionnaires and an interview were used to assess neurological and socioeconomic status, development and current educational placement, behavioural profile and handedness of family members. Birth records and brain scans (CT) were examined. Strict inclusion criteria ensured the unilaterality of the lesion. There were more right than left hemiplegic children identified and relatively more males than females in the left hemiplegic group. The two hemiplegic groups were similar on all descriptive and developmental data. They differed significantly from the controls only in that the left hemiplegic group was more premature and smaller at birth; ...

To study the recovery of walking in an 85 year old man who had right hemiplegia after suffering a cerebral infarction, electromyograms (EMGs) were recorded from his leg muscles. We used signs for instability that we derived from EMG patterns seen in the developmental process of normal infants. The myoelectric activity at one month after the stroke showed many patterns indicative of unstable walking, closely resembling activity patterns seen in very unstable independent gait of a one year old baby in the first month of learning to walk. Seven months later, these patterns indicating unstable gait tended to have decreased or disappeared, although some marked activity betraying instability still remained. However, when the patient walked with the support of a hand cart and was able to hold his trunk upright, these excessive muscular activities decreased or disappeared, closely resembling the stable adult walking pattern. We recommend further study of the evaluation of recovery of walking after stroke by comparing the patient’s EMG patterns to those not only of normal adult human gait, but also of the development of human walking in early childhood.

In 1928, Baló described a law student with an unusual fatal illness marked by aphasia and a right hemiplegia, with later optic neuritis and normal cerebrospinal fluid. At autopsy, he found a disease of the white matter characterised by foci varying in size from a lentil to that of a pigeon’s egg and presenting gray softening and, in part, concentricity, where the medullary sheaths were destroyed and the axis cylinders were intact. He was uncertain whether this was a variant of acute multiple sclerosis or of Schilder’s disease. The basis of concentric sclerosis is still unclear though current opinion favours a variant of acute multiple sclerosis.

A list-learning paradigm was used to study learning and memory of verbal and figurative material in children with right versus left-sided hemiplegic cerebral palsy. Thirty-one children with right (n = 18), or left (n = 13) congenital hemiplegia were compared with normal controls (n = 19). All children had normal intelligence (IQ > 80), and were attending standard schools. The inclusion criteria for the two hemiplegic groups were; no epilepsy, no hearing or visual impairments, and a mild to moderate hemiparesis. The aim of this study was to explore material-specific (words and drawings) differences in the acquisition, recall and serial position effects in children with an early unilateral brain lesion. The left-hemisphere impaired (i.e. right hemiplegia) group showed impaired acquisition for drawings, as compared with the normal controls. There was also a material-specific difference in the serial position effect for all three groups. Learning of words followed the primacy principle, whereas the learning of drawings followed the recency principle. There were no group-differences in delayed-recall (i.e. long-term memory) for either words or drawings. The results are discussed in terms of acquisition and retention of verbal and figurative materials in relation to lesion side and size.

Although inpatient stroke rehabilitation provides clinicians with the opportunity to prepare patients for continuation of prestroke activities, little is known about the patients' ability to safely resume driving at the point of discharge to the community.To compare foot pedal response times of 20 stroke patients with right hemiplegia (RH) or left hemiplegia (LH) and 10 controls.A cross-sectional design was used. Response times were measured using 3 foot pedal operation techniques: (1) right-sided accelerator with right leg operating accelerator and brake, (2) right-sided accelerator with left leg operating accelerator and brake, and (3) left-sided accelerator with left leg operating accelerator and brake. Outcomes included reaction time (RT), movement time (MT), and total response time (TRT).Controls demonstrated faster RT than patients with RH (263 vs 348 ms; P.001) or LH (316 ms; P.05) for all conditions, as well as faster MT than patients with RH (P.05 for all) but not LH when using the right leg (258 vs 251 ms; P = .82). Controls demonstrated faster TRT than patients with RH (P.001 for all) but not LH when using the right leg (515 vs 553 ms; P = .44).When using the nonparetic leg, patients with LH had braking response times comparable to controls, but patients with RH demonstrated significant impairment of both the paretic and nonparetic legs.

Background:Septoplasty is one of the most common otolaryngological operations. It is often dismissed as a simple procedure, despite the wide range of potential complications. We describe the first reported case of unilateral hemiplegia as a complication of septoplasty.Methods and results:A 51-year-old man presented with right hemiplegia following a septoplasty and turbinoplasty procedure carried out elsewhere. Cranial imaging showed a breakthrough fracture of the left sphenoid sinus anterior wall and clivus, with a haemorrhagic area in the left paramedian pons, which was responsible for the patient's right hemiplegia. Despite neurological and physiotherapeutic rehabilitation, the patient gained only partial recovery from his right hemiplegia.Conclusion:Good intra-operative visualisation and appropriate surgical technique are essential to prevent complications and achieve a functional nasal airway. The importance of the presented case to the pre-operative informed consent process is underlined.

In developing a training program from standing to walking for a patient with a left parietal foot amputation and right hemiplegia, we found that the leg orthosis was effective in allowing the patient to regain the balancing ability when standing. The leg orthosis had practical effects on increasing walking distance.

Global aphasia is an acquired language disorder that seriously affects comprehension, language expression, reading and writing, showing a right hemiplegia. Because of this inability to process language and these motor difficulties, global aphasia is the worst prognosis aphasia. Sometimes patient’s rehabilitation abilities to take advantage of rehabilitation and to restore a functional communicative interaction with the environment are underestimated. Here we report a case in which a patient with global aphasia comes in the healthcare service of the Pontificia University of Salamanca after an unsuccessful period of traditional rehabilitation and recovers some communication skills through training in communication through signs.Keywords: Global aphasia, treatment, no voice communication.Resumen.La afasia global es un trastorno adquirido del lenguaje que afecta gravemente a la expresión, la comprensión, la lectura y escritura, cursando además con una hemiplejia derecha. Esta imposibilidad para el procesamiento del lenguaje y las dificultades motrices la convierte en la afasia de peor pronóstico. de esta forma, en algunas ocasiones se sibestiman las capacidades del enfermo para aprovechar la rehabilitación y poder reestablecer una interacción comunicativa funcional con el entorno. presentamos un caso en el que un paciente con afasia global acude al ServicioAsistencial de la Universidad Pontificia de Salamanca. TRas un periodo de rehabilitación tradicional, sin éxito, logra recuperar cierta capacidad de comunicación a través de un entrenamiento en comunicación signada.Palabras clave: afasia global, tratamiento, comunicación no vocal.

The typical picture of a patient suffering from a left hemisphere cerebral vascular accident (CVA) is that of an aphasic with a right hemiplegia. In such patients the impairment in speech is generally mirrored in written production (Basso et al. 1978). By necessity this agraphia is demonstrated in the left, non-dominant, non-paralysed hand. Due to the concomitant hemiplegia, writing is not normally examined in the dominant right hand. (This situation also holds for praxis.) This raises an important question: in patients with right hemiplegia, could it be demonstrated that the writing disturbance reflects a unilateral left agraphia? In other words, could the dominant, paralysed hand produce written language better than the non-dominant but unparalysed left hand?

An 8-month-old boy presented with right hemiplegia of sudden onset after 20 days of Kawasaki disease, which was not initially treated by gamma globulin. Cranial X-ray computed tomography confirmed cerebral infarction as the cause of the right hemiplegia. In subsequent weeks, he developed multiple thromboses in coronary aneurysms. He successfully underwent intracoronary thrombolysis using tissue plasminogen activator without haemorrhagic complications. Cerebral infarction as a complication of Kawasaki disease is rare, and is a difficult clinical situation to manage.

A 26-year-old woman currently treated for systemic lupus erythematosus with steroid therapy presented with sudden onset of right hemiplegia. Computed tomography of the brain showed a large frontoparietal ring-enhanced lesion with perifocal edema. Stereotactic aspiration of the lesion revealed Cladosporium bantianum. The size of the abscess did not reduce in spite of optimum antifungal treatment. The abscess was subsequently excised through a frontoparietal craniotomy. At follow up after 24 months, there was no recurrence of the abscess. Cerebral Cladosporium bantianum infection is usually refractory to antifungal agents and the prognosis is very poor. This patient had the longest survival period in a case of Cladosporium brain abscess so far reported.

A 49-year-old woman with recently diagnosed hypertension, developed sudden onset aphasia and right hemiplegia. A CT of her brain showed a large left subcortical haemorrhage. Dynamic CT-angiography showed dramatic contrast extravasation (see fi gure and webvideos) sug gesting ongoing bleeding, and corres ponding to rapid neurological deterioration. Our patient had urgent sur gical evacuation of the haematoma. Her neuro logical symptoms subsequently stabilised. Surgical exploration, pathology, and postoperative conventional angiography did not show a vascular malformation. The

A 12-year-old girl arrives unresponsive in a Port-au-Prince emergency department, with labored breathing and right hemiplegia. In one of the few functioning ICUs in Haiti, premature death is no longer automatic. But in such an environment, how far do you go to extend life?

A 64-year-old man was evaluated for seizures due to traumatic brain injury 25 years previously. Physical examination revealed aphasia, right hemiplegia, and clubbing of all fingers of the hemiplegic arm (figures 1 and 2). Digital clubbing is a bulbous beaked fingertip deformity due …

We report a case of Tolosa-Hunt syndrome in a 4-year-old girl. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) revealed a left cavernous sinus involvement with internal carotid artery occlusion. Clinical signs included left ophthalmoplegia, convulsions and right hemiplegia. Etiopathogenesis of this syndrome is unclear but as in our case, response to corticosteroid therapy is spectacular and avoids unnecessary invasive diagnostic procedures. We underline the importance of cross-sectional imaging in the diagnostic approach. Several other diseases including tumors, vascular lesions and infections can have a similar clinical and/or imaging presentation. However, closely monitored evolution on imaging proves to be decisive in the establishment of final diagnosis of this syndrome.

A 76-year-old man presented with a sudden disturbance of consciousness and right hemiplegia. An initial computed tomographic examination revealed multiple hematomas. The laboratory studies were highly suggestive of disseminated intravascular coagulation, although the underlying diseases were unknown at the time of admission. Despite various attempts at management, including replacement therapy, bleeding was not controlled and the patient died on day 5. An autopsy revealed the presence of prostate and rectal cancers. This case illustrates the fact that a fatal intracranial hemorrhage can be the first manifestation of disseminated intravascular coagulation in association with malignancy.

A 78-year-old woman was admitted to the hospital because of ischemic stroke with regressive right hemiplegia. Two years earlier, she had undergone a supra-annular mitral valve replacement with a porcine bioprosthesis (St Jude Medical Epic No. 27, St. Jude Medical, Inc., St. Paul, Minn). Because of paroxysmal atrial fibrillation, she had received vitamin K antagonist treatment since the surgery. At admission, the patient was asymptomatic and had no fever. Physical examination revealed a 2/6 apical diastolic murmur. Transthoracic echocardiography performed at admission revealed several extensive vibratile masses attached to the prosthesis ring. Mean mitral gradient was 11 mm Hg, which indicated prosthesis obstruction. Maximal systolic pulmonary pressure was 47 mm Hg. Left ventricular ejection fraction was 50% as assessed by …

We report a case of branch atheromatous disease (BAD) presenting capsular warning syndrome, who subsequently showed a complete recovery by the combination therapy as described below. A 54-year-old man with untreated hypertension was admitted to our hospital because of dysarthria and right hemiplegia. The NIHSS on admission was 12 points, but his symptoms soon completely disappeared during examination. After admission administration of aspirin, heparin, atorvastatin and t-PA were started, but stereotyped episodes of dysarthria and the right hemiplegia occurred repeatedly. We added plasma expander, and he thereafter revealed no further ischemic episodes at 22 hours from admission. Over all, he had 15 times of transient ischemic attack with no lasting deficit. The DWI scan obtained 5 hours after the onset demonstrated a high-intensity region in the left putamen to corona radiata. MRA showed no significant abnormalities. He had been diagnosed as having branch atheromatous disease with capsular warning syndrome. The present case suggests that combination therapy including t-PA and plasma expander may be effective to BAD presenting capsular warning syndrome.

Common carotid pseudoaneurysms are very rare. The authors report a case of a 18-year-old patient with 11 cm large posttraumatic pseudoaneurysm of the right common carotid artery caused by a gunshot in the neck. The patient also had a right hemiplegia, secondary to the left sylvian artery stroke and aphasia. A surgical repair was undertaken with an approach including a total sternotomy. The aneurysm was excluded and a saphenous vein patch was used to repair the 2-cm defect on the arterial wall. The postoperative period was uneventful. This is probably the largest carotid artery aneurysm ever described. The potential hazards of an aneurysm of the common carotid artery indicate that surgical treatment is warranted particularly in a patient with a past history of controlateral stroke.

Two case studies are presented which demonstrate the therapeutic utility of a new prosthesis to aid the treatment of agraphia in hemiplegic aphasics.

The transfer of training approach to the treatment of visual perceptual deficits was evaluated with four right hemiplegic stroke patients, using single-case experimental designs. The results showed little evidence of effective treatment for individual perceptual deficits. Perceptual stimulation alone may have produced some general improvements. The importance of perceptual assessment and the monitoring of progress is discussed.

We report a young patient who was operated on for a penetrating slow impact craniocerebral injury in the left frontal region caused by an axe. The patient was admitted comatose, with right hemiplegia. The blade of the axe was embedded deeply into his head. A craniectomy was carried out around the axe blade and it was removed easily. The cerebral wound was 6cm long in horizontal plane and about 7cm deep. Significant amount of contused and necrotic brain tissue was aspirated. The patient showed an uneventful recovery.

Introduction Semi-solid nutrition with high viscosity has the advantage of reducing gastroesophageal reflux and diarrhea and shortens the duration of administration compared with liquid nutrition. This is the first report describing the administration of semi-solid nutrition with high viscosity via a nasogastric tube, which achieved a remarkable improvement in the patient's nutritional state. Case presentation A 67-year-old man (mongoloid race, Japanese) with tuberculosis, a pressure ulcer and malnutrition was admitted to our hospital. He also had right hemiplegia, dysphagia and aphasia as sequelae of a cerebral hemorrhage. Before his admission, he had been treated at another hospital with 600 kcal/day of liquid nutrition via a nasogastric tube, which was insufficient and induced severe malnutrition. After he was admitted to our hospital, we increased the quantity of his liquid nutrition without success because of complications, specifically diarrhea and gastroesophageal reflux. As it was difficult to confirm whether or not he would accept gastrostomy feeding, we administered semi-solid nutrition with high viscosity (20,000 mPa x s) via a large-bore nasogastric tube (18 French). Soon after he was started on semi-solid nutrition, his pressure ulcer and malnutrition improved without diarrhea or complications accompanying the large-bore nasogastric tube. Conclusion When patients have problems with liquid nutrition, such as diarrhea or gastroesophageal reflux, semi-solid nutrition via a nasogastric tube is a useful method of achieving improvements in nutritional state in a short period of time.

OBJECTIVE. This case report describes the use of modified constraint-induced movement therapy (CIMT) to improve upper-limb function in a 12-month-old child with right hemiplegia. It also describes parent concerns about CIMT and documents the short- and long-term effects of modified CIMT. METHOD. The participant was assessed 5 times over a 7.5-month period using the Peabody Developmental Motor Scales–2, Pediatric Motor Activity Log, Toddler Amount of Use Test, and Knox Parent Questionnaire. CIMT included a nonremovable cast worn on the unaffected arm and approximately 8 hr per week of occupational and physical therapy for 2 weeks. RESULTS. Benefits of improved upper-limb function measured immediately after CIMT were sustained at 6 months’ follow-up. No adverse events related to cast use were reported. DISCUSSION. The findings from this case report suggest that CIMT was a safe intervention associated with improving upper-limb function for this young child with hemiplegia.

Conversion disorder is seen most frequently in the young. The authors present a case report of a 79 year old patient admitted to a medical floor with recurrent right conversional herniplegia (paralyses of one side of body). The significance of an underlying somatization disorder is emphasized because the majority of these patients will be free of organic disease. The abnormal neurological signs that are absent in conversion are reviewed. Finally, the authors comment on the unique lateralization of conversion symptoms to the body's left side. The need for further research with uniform definitions of somatization and conversion disorder is needed.

The case of a 49-year-old female with a left parietal convexity meningioma associated with an acute subdural hematoma is described. She was admitted because of sudden onset of severe headache accompanied by nausea and vomiting. She was also confused, and 6 hours after admission she developed lethargy, right hemiplegia, and left mydriasis with no pupillary reaction to light. Computed tomography disclosed a round, extra-axial mass in the left parietal region; it was heterogeneously enhanced. Emergency craniotomy, performed after carotid angiography, revealed a tumor with a massive underlying subdural hematoma. The histological diagnosis was meningotheliomatous meningioma, and there were many meningothelial cells within the hematoma.

At 45 years of age, Charles Baudelaire suffered a left hemispheric stroke that left him with a right hemiplegia and severe aphasia. In this chapter, we investigate the nature of his symptoms, drawin

Primary cardiac tumors are rare, and most are myxomas. Only approximately 5% of cardiac myxomas originate from the ventricles. We report the case of a 23-year-old man presenting with right hemiplegia and muscle strength degeneration under a diagnosis of stroke. Transthoracic echocardiography revealed a 29 × 26 mm mass arising from the anterior interventricular septum. The tumor was surgically removed, and histology confirmed the diagnosis of left ventricular myxoma. We report its clinical features and treatment to add to the current knowledge.

A síndrome da veia cava superior (SVCS) é condição relativamente rara. Relatamos o caso de um paciente de 42 anos, masculino, hipertenso há 15 anos, que evoluiu com dor cervical e torácica há um um ano, sendo evidenciada oclusão de 95% da coronária direita. Submetido a angioplastia, porém com persistência da dor torácica. Posteriormente evoluiu com episódios recorrentes de hemiplegia à direita associados a crises hipertensivas, que melhoravam com medicamentos anti-hipertensivos. Pela presença de coloração vinhosa na face e acentuação durante os períodos de ataques isquêmicos transitórios, foi feita a suspeita diagnóstica de provável acometimento do sistema de drenagem venosa, confirmada à venografia pelo achado de dilatação da veia jugular direita e imagem de estreitamento importante na junção com a veia cava superior. Em conclusão, não foi possível definir com certeza a relação entre as duas patologias no caso aqui apresentado, porém chamou a atenção a melhora dos sintomas neurológicos após o controle da SVCS com o tratamento instituído.

Secondary Moyamoya disease, also known as Moyamoya syndrome has been rarely associated with Down syndrome. In pediatric patients, the usual presentation is that of ischemic stroke. Here is reported a 4-year-old child with Down syndrome and Moyamoya syndrome who presented with acute-onset right hemiplegia. A high index of suspicion is necessary to make the diagnosis.

A 57-year-old woman had transient right hemiplegia 2 days after physical stress. An electrocardiogram exhibited T-wave inversion with QT prolongation. An echocardiogram revealed akinesia of the entire left ventricle except for the basal region. Cranial computed tomography and transthoracic echocardiography revealed an apical thrombus that disappeared 1 month later. Coronary angiography was normal. After 3 months, left ventricular wall motion had completely normalized.

A 58-year-old woman was admitted to our hospital with lethargy, right hemiplegia, and right homonymous hemianopia. An emergency CT showed a large hemorrhage in the left putamen and …

A 76 year old woman was referred with a right hemiplegia. She was on treatment for hypertension, angina pectoris, and dyslipidaemia. She had been complaining of pain in the right leg and increasing exertional dyspnoea for two days when she suddenly experienced …

OBJECTIVE: To assess the motor function of the left, supposedly unaffected, limbs of patients with an acute right vascular hemiplegia. METHODS: Fifteen patients with an acute vascular right hemiplegia and 16 matched healthy controls were studied. Motor function of the left limbs of each patient was evaluated on days 20 and 90 after their stroke using four validated tools (hand dynamometer, isokinetic dynamometer, finger tapping, and nine hole peg test). RESULTS: There was a significant impairment of motor function of the left limbs of patients at day 20 compared with controls. The impairment had recovered almost completely at day 90 after the stroke. CONCLUSION: These results show the bilateral cerebral representation of the human motor system and suggest the participation of ipsilateral motor pathways in recovery after a stroke.

Paciente masculino de 39 anos, com quadro de abdomen agudo de evolução de 72 horas, foi submetido a apendicectomia. Desenvolveu 14 dias após, quadro de cefaléia, vômitos, afasia, torpor, hemiplegia à direita e rigidez de nuca. A tomografia computadorizada craniana mostrou múltiplos abscessos cerebrais supra tentoriais bilateralmente. Após punção aspirativa do maior deles foi instituída antibióticoterapia resultando em cura do paciente.

We investigated the possibility of instructing people in how to assist patients with activities of daily living via videoconferencing. A videoconference system was installed in two rooms to simulate a connection between a home and an institution. The subjects were five first-year university students. First, they saw a video-tape on several general assistance procedures to help a patient with sitting up, standing up and walking with a cane. Then they assisted a simulated patient who reproduced the effects of right hemiplegia due to a stroke. They also received instructions from a physiotherapist in another room using the videoconference system. The students experienced most difficulty in assisting the patient to stand up from sitting with legs stretched in a tatami room. Their mean score in the first session for this was 34.5 points out of 45, and this increased to 38.5 in a second session, after a question and answer period. The present study shows that the delivery of rehabilitation services is feasible in remote places.

A 61-year-old man with a prior history of hypertension presented to the emergency department with loss of counsciousness and right hemiplegia. His physical examination revealed low blood pressure (80/50 mmHg on both arms) and normal sinus rhythm on electrocardiogram. Diffusion magnetic resonance imaging showed a relatively large infarct in the left parietal hemisphere. The cardiovascular examination was …

Amebiasis is a parasitic infection with manifestations, mainly digestives. It is rarely described extra-gastrointestinal locations including the brain. We report the case of a patient aged 42, made five months earlier for an appendectomy, and was admitted to the ICU after a convalescent stable uncomplicated. At admission, he was 12/15 in Glasgow and had a right hemiplegia. Brain CT revealed a discrete diffuse hypodensities perilesional edema. An abdominal ultrasound found an aspect for multiple hepatic abscesses. Abscess puncture was performed, which was not conclusive, and no seed could be identified. On Ultrasound, no cardiac abnormalities were found, and no endocarditis was present. And since the appearance macroscopic (chocolate-brown), amebic serology is performed and has been highly positive. The therapeutic management included an intubation and ventilation as well as a tri-antibiotic-based ceftriaxon, metronidazol and gentamycin. Confirmation of amebiasis required high doses of metronidazol for an extended period. The replay of the play was an appendectomy for an amebome. Evolution was favorable. Amebiasis can have extraintestinal locations, issues to think about including the cerebral forms.