著者

KATO Masaki TAKASUGI Jun ICHIKAWA Takeo OGA Tatsuhide

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

pp.200508, (Released:2020-05-28)

---

There are few case reports of patients with hemiparetic stroke who had previously been diagnosed with poliomyelitis (polio). Herein, we present the case of an 84-year-old male stroke patient with right-sided hemiparesis and polio. He was infected with polio at age 6 and had severe right-leg palsy. He was able to walk independently, performed knee hyperextension, and walked using a cane prior to the stroke at age 84. He was transferred to our hospital 31 days post-stroke. At that time, manual muscle test (MMT) was Poor-to-Good for the right ankle muscles and Trace for the right hip and knee muscles. He required assistance from a therapist to walk even with grasping parallel bars because he could not hyperextend the right knee and the knee had collapsed. For physical therapy, he performed stretching, muscle strengthening, standing, and walking exercises. Consequently, he was able to walk with a walking frame independently at discharge (day 131 after the onset). He regained knee hyperextension and resolved the knee collapse. MMT for the right hip muscles became Poor. This hemiparetic stroke patient with polio had severe right leg palsy and consequently had trouble walking due to knee collapse. It is postulated that regaining the knee hyperextension enabled him to walk safely.

著者

SAKO Rikitaro KATO Masaki MURAYAMA Takashi ENOKIDANI Takahiro OTA Takayuki HONDERA Tetsuichi FUJII Ami OZASA Yoshifumi

出版者

脳機能とリハビリテーション研究会

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.20, no.JPN, pp.49-55, 2020 (Released:2020-10-09)

---

Right-sided unilateral spatial neglect (USN) of patients with left hemisphere stroke disappears within a few months from the onset. Also, it has been reported that right-sided USN of bilateral hemisphere lesions patients persists even after 6 months from the onset. Herein, we present the case of a left middle cerebral artery stroke patient with persistent right-sided USN. The patient was right-handed female in her eighties. She was diagnosed with myelodysplastic syndrome 12 years before and then had severe anemia. She suffered from stroke and was hospitalized. She complained of severe right-sided hemiparesis, sensory disturbance, USN, and aphasia. During hospitalization, the laboratory tests revealed a hemoglobin level of 6.0 – 10.2 g/dL and hematocrit level of 18.3–31.8 %. She underwent rehabilitation for fatigue from the anemia. However, her right-sided hemiparesis and USN persisted, and on day 174 post onset she needed support for activities of daily living. Studies have reported that the persistence of the right-sided USN with left hemisphere lesions have a strong relationship with hypoperfusion in the left hemisphere and right parietal regions, even if the right hemisphere has no lesion at all. The decrease in the bilateral hemisphere function is known to hinder the improvement of right-sided USN. Severe anemia (hematocrit level 21.0 %) has also been reported to decrease the oxygen metabolism of whole brain cortex. From these studies severe anemia was thought to hinder the improvement of right-sided USN.

著者

KATO Masaki TAKASUGI Jun ICHIKAWA Takeo OGA Tatsuhide

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.20, no.1, pp.13-18, 2020 (Released:2020-10-09)

---

There are few case reports of patients with hemiparetic stroke who had previously been diagnosed with poliomyelitis (polio). Herein, we present the case of an 84-year-old male stroke patient with right-sided hemiparesis and polio. He was infected with polio at age 6 and had severe right-leg palsy. He was able to walk independently, performed knee hyperextension, and walked using a cane prior to the stroke at age 84. He was transferred to our hospital 31 days post-stroke. At that time, manual muscle test (MMT) was Poor-to-Good for the right ankle muscles and Trace for the right hip and knee muscles. He required assistance from a therapist to walk even with grasping parallel bars because he could not hyperextend the right knee and the knee had collapsed. For physical therapy, he performed stretching, muscle strengthening, standing, and walking exercises. Consequently, he was able to walk with a walking frame independently at discharge (day 131 after the onset). He regained knee hyperextension and resolved the knee collapse. MMT for the right hip muscles became Poor. This hemiparetic stroke patient with polio had severe right leg palsy and consequently had trouble walking due to knee collapse. It is postulated that regaining the knee hyperextension enabled him to walk safely.