Pushing behavior and hemiparesis: which is critical for functional recovery in pusher patients ? Case report

• Autor(a) principal: Santos-Pontelli,Taiza E.G.
• Data de Publicação: 2007
• Outros Autores: Pontes-Neto,Octávio M., Colafêmina,José Fernando, Araújo,Dráulio B. de, Santos,Antônio Carlos, Leite,João P.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Arquivos de neuro-psiquiatria (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2007000300035
• topic: postural control; pusher syndrome; stroke; thalamic hemorrhage

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.