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Updated: Jul 16, 2026
Cognitive Function and Upper Limb Rehabilitation Training Post-Stroke Using a Digital Occupational Training System
Published on: December 29, 2023
Urgent intervention to reduce functional deficits after postoperative stroke
Andrew W Lee1, Cameron Davis, H Adrian Puttgen
1Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 126, Baltimore, MD 21287, USA. alee74@jhmi.edu
Background:
A 67-year-old right-handed man with a history of atrial fibrillation developed sudden aphasia after urological surgery. Initial diffusion-weighted and perfusion-weighted MRI demonstrated an area of hypoperfusion in Broca's area, with minimal infarction.
Investigations:
Neurological examination, language testing and brain MRI scans with diffusion-weighted and perfusion-weighted imaging.
Diagnosis:
Acute cardioembolic stroke with minimal infarction in Broca's area and a surrounding region of potentially salvageable, hypoperfused cortex.
Management:
Saline-induced hypertension resulting in rapid restoration of cortical perfusion and a resolution of the initial speech and language deficits. The utility of perfusion-weighted imaging in selecting appropriate candidates for urgent treatment of stroke when thrombolysis is contraindicated is discussed.
