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Contraversive pushing in non-stroke patients.
Taiza E G Santos-Pontelli1, Octávio M Pontes-Neto, José Fernando Colafêmina
1Dept. of Neurology, University of São Paulo, School of Medicine at Ribeirão Preto, Campus Universitário, Ribeirão Preto, CEP 14049-900, Brazil.
Journal of Neurology
|December 14, 2004
Summary
Pusher syndrome, characterized by active pushing away from the non-paretic side, can occur in non-stroke brain injuries. Recovery time varies based on the cause, with traumatic brain injury patients recovering faster than stroke patients.
Area of Science:
- Neurology
- Neuroscience
- Rehabilitation Medicine
Background:
- Pusher syndrome is a postural control disorder linked to hemiparesis from brain damage.
- This behavior, involving active pushing and resistance to correction, typically leads to falls towards the paralyzed side.
- Previously, pusher syndrome was exclusively associated with stroke patients.
Purpose of the Study:
- To investigate the occurrence and characteristics of pusher behavior in patients with acute encephalic lesions.
- To analyze imaging features and clinical evolution of pusher behavior in a diverse patient group.
- To determine if pusher behavior is exclusive to stroke patients or occurs in other neurological conditions.
Main Methods:
- Identified pusher patients from 530 inpatients over one year.
- Utilized the standardized Scale for Contraversive Pushing (SCP) for evaluation.
- Conducted neurological examinations, neuropsychological assessments, ADL evaluations, and neuroimaging studies.
Main Results:
- Eight patients (1.5%) exhibited severe contraversive pushing.
- Six patients (75%) had right-hemisphere brain damage.
- Four patients had stroke etiology; four had non-stroke etiology (three traumatic, one tumor).
- Stroke patients recovered in a mean of 15.3 weeks; traumatic brain injury patients recovered in a mean of 5 weeks.
Conclusions:
- Contraversive pushing can occur in patients with non-stroke neurological lesions.
- Symptom resolution may differ based on the underlying neurological etiology.
- This study expands the understanding of pusher syndrome beyond stroke-related cases.