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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to evaluate the possible psychopathological symptomatology the authors analyzed the results of a clinico-dynamical observation of 176 patients in the acute period of a stroke. Among 128 patients with the right hemisphere localization of the focus (the main group) in 60 cases (47%) there were revealed psychopathological symptoms whereas in the control group (48 cases) with left hemispheric foci only 2 patients (4.2%) such disturbances were noted. The main expressions of psychopathological syndromes in patients with lesions of the right hemisphere were anosognosia, certain emotional reactions in the form of euphoria, a drop in purposeful activity, motor and mental aspontanity and specific confabulatory disorders. The qualitative and quantitative specificity of psychopathological syndromes in focal vascular lesions of the right hemisphere is supplementary material for further deep studies of the functional asymmetry of the brain hemispheres.
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PMID:[Psychopathologic symptomatology and its prognostic value in the acute period of right hemisphere strokes]. 97 13

An overall measure of the recovery of visual neglect in patients with an acute stroke is described: The "Visual Neglect Recovery Inde" (VNRI) expresses the amount of visual neglect on a battery of visual neglect tests as a percentage of complete recovery from the maximal visual neglect measurable. The principles underlying the development of the index are similar to those involved in the development of the Motricity Index for hemiplegia. A population of 68 survivors of stroke who presented with visual neglect at two to three days were followed for up to six months. The VNRI showed that neglect was greater in those with right hemisphere stroke than in those with left hemisphere stroke and that recovery was most rapid over the first 10 days and reached a plateau at three months. Most patients, including many with severe initial visual neglect, showed little visual neglect at three months. Stepwise regression analysis showed that the severity of visual neglect at three months and at six months post-stroke could be predicted by the severity of visual neglect and the presence of anosognosia at two to three days. A regression equation was produced which may enable clinicians to select patients for intensive treatment of visual neglect.
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PMID:Measuring visual neglect in acute stroke and predicting its recovery: the visual neglect recovery index. 161 6

A right handed man had a massive left middle cerebral artery stroke. CT and MRI revealed extensive destruction of both anterior and posterior areas typically associated with language. There was, however, no aphasia, but instead a marked limb apraxia, dyscalculia, dense right visual neglect, and anosognosia. These uncommon dissociations and associations support the hypothesis that cerebral control of motor function of the limbs is not fundamentally related to the motor control involved in speech, and the notion that handedness is related to laterality of motor control, and only accidentally to laterality of language control.
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PMID:Limb apraxia without aphasia from a left sided lesion in a right handed patient. 171 36

We compared patients with unawareness of hemiplegia lasting more than 1 month after right hemisphere stroke with other patients with right hemisphere stroke who became aware of hemiplegia within a few days after onset. Patients with persistent unawareness invariably had severe left hemisensory loss and usually had severe left spatial neglect. They were almost always apathetic; their thought lacked direction, clarity, and flexibility, and they had at least moderate impairment of intellect and memory. Their right hemisphere strokes were large and always affected the central gyri or their thalamic connections and capsular pathways. In addition, there was evidence of at least mild left hemisphere damage, most commonly caused by age-associated atrophy. The pathogenesis of anosognosia for hemiplegia may involve failure to discover paralysis because proprioceptive mechanisms that ordinarily inform an individual about the position and movement of limbs are damaged, and the patient, because of additional cognitive defects, lacks the capacity to make the necessary observations and inferences to diagnose the paralysis. We discuss the implications of this "discovery" theory and contrast it with other explanations of anosognosia.
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PMID:The pathogenesis of anosognosia for hemiplegia. 194 7

A patient is described who, following a post-eclamptic intravascular disseminated coagulation, had a bilateral stroke in the territories supplied by the posterior cerebral arteries. She showed an anosognosia of her cortical blindness associated with a severe recent memory loss.
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PMID:Anton's (-Redlich-Babinski's) syndrome associated with Dide-Botcazo's syndrome: a case report of denial of cortical blindness and amnesia. 245 Dec 81

Eleven of 134 patients with a right hemisphere stroke responded to stimuli directed at other patients as if the stimuli were directed at them. The stroke was severe in all 11 patients. Associated disturbances included hemineglect, anosognosia, motor impersistence, disorientation (sometimes with agitated confusion), and somatosensory delusions and allesthesia. This form of perseveration seems specific to acute right hemispheric stroke.
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PMID:Response-to-next-patient-stimulation: a right hemisphere syndrome. 339 72

The dextrocerebral stroke is often underestimated as a result of its deficits--in contrary to the left cerebral stroke with the aphasia--because the patient's neglect of the plegic side is transferred to the therapist. A key to understanding this is the hypothesis that the anosognosia results in a loss of spatial analysis. After a survey of the different functions of the left and right hemispheres the author demonstrates the symptoms, diagnosis and therapeutic prognoses. The therapy needs to be continued for several months. In addition, the patient's social environment is important.
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PMID:[The disorder of space analysis as a key to understanding anosognosia in right-sided cerebral infarct]. 340 81

The results of polygraphic examination of night sleep in 40 post-stroke patients are presented. In 22 of these patients, the focus was localized in the left, and in 18, in the right hemisphere. The pattern of sleep was found to vary with the hemispherical lateralization of the pathological process. Patients with damage to the left hemisphere and aphasia exhibited differences in the phase of rapid sleep and the time-course of the activation phenomena on the EEG during sleep related to the degree of speech disturbances. When the right hemisphere was impared, the most marked disturbances of the sleep pattern were elicited in patients with prominent manifestations of anosognosia. The data obtained are considered as features characteristic of the dysfunction of the cerebral nonspecific systems associated with hemispherical damage.
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PMID:[Polygraphic features of the structure of nocturnal sleep in pathology of the left and right hemisphere in stroke patients]. 402 16

We studied recovery of function in 41 patients with right hemisphere stroke. Recovery was rapid for left neglect, prosopagnosia, anosognosia, and unilateral spatial neglect on drawing (USN). Recovery was slower for h mianopia, hemiparesis, motor impersistence, and extinction. Rates of recovery were intermediate for constructional apraxia and dressing apraxia. Sex had no influence on the rate of recovery. Younger patients recovered from prosopagnosia more rapidly than older patients. Patients with smaller lesions recovered more quickly from anosognosia, USN, and hemiparesis than patients with larger lesions. Patients with hemorrhages recovered more rapidly from constructional apraxia, neglect, and motor impersistence than patients with infarcts. Recovery of function and the factors influencing recovery can by studied systematically by life table methods.
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PMID:Recovery of behavioral abnormalities after right hemisphere stroke. 668 80

Neurobehavioral sequelae of strokes can limit a patient's ability to describe or express emotion, can cause him to give "yes" answers to the clinician who expects them, or can directly cause apathy or crying spells. Also, anosognosia for depressive signs can cause the patient to deny depressive signs that are objectively observable. These diagnostic confounders have not been adequately assessed in previous research on poststroke depression; thus many studies are of doubtful validity, as shown by studies of the dexamethasone suppression test for melancholia in stroke patients. Future studies on depression after stroke must prospectively rule out fluent aphasia, motor aprosody, and amnesia before relying on diagnostic information from the psychiatric interview, and the interview should always be supplemented by direct observation of vegetative signs and other behavior. With this extended information, major depression can and should be diagnosed using accepted symptom and duration criteria.
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PMID:Diagnosing depression after stroke. 759 71


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