著者

Minori Kurosaki Masahiko Tosaka Yoko Ibe Hironori Arii Junichi Tomono Masayuki Tazawa Tatsuya Shimizu Masanori Aihara Yuhei Yoshimoto Naoki Wada

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220039, 2022 (Released:2022-08-04)

参考文献数

27

被引用文献数

1

---

Objectives: Stroke patients with hemiplegia can sometimes achieve independent life at home or in light care facilities after rehabilitation. This study examined the outcomes of rehabilitation in stroke patients with severe hemiplegia.Methods: This study included 50 patients with Brunnstrom recovery stage I–II hemiplegia at the start of rehabilitation for stroke. Good outcome after rehabilitation was defined as independent life with functional independence measure (FIM) score of 100 or greater. Predictors for post-rehabilitation functional recovery were statistically analyzed.Results: FIM scores of 100 or greater in 12 of 50 patients (24%) allowed independent life after stroke rehabilitation. According to univariate analysis, factors associated with a FIM score of 100 or greater and good prognosis after rehabilitation were younger age (<70 years), paralysis caused by intracerebral hematoma (ICH), no cortical lesions, short time from admission to comprehensive inpatient rehabilitation (CIR) for stroke (within 1 month), and good status at the start of early rehabilitation and CIR. Eleven of the 12 patients with good prognosis (FIM ≥100) had ICH and a basal ganglia lesion with no cortical damage. Analysis of the location of lesions suggested that many patients with basal ganglia ICH lesions and little cortical involvement have good prognoses.Conclusions: Stroke patients with severe hemiplegia showed a slightly different distribution of lesions between ICH and cerebral ischemia. Cortical involvement may be a prognostic factor for outcome after rehabilitation in stroke patients with severe hemiplegia. More aggressive rehabilitation interventions may be important for patients with severe hemiplegia, especially without cortical involvement.

著者

Hiroyuki Mizuno Masanori Aihara Koji Sato Chikashi Negishi Nobuo Sasaguchi Hideyuki Kurihara Yuhei Yoshimoto

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

pp.oa.2022-0039, (Released:2022-10-14)

参考文献数

16

---

Objective: Evaluation of intracranial stent placement by MRI suffers the problems of signal artifacts during time-of-flight MRA (TOF-MRA). Therefore, angiographic examination is required for detailed intravascular assessment of the stent placement site. Recently, 3D T1-turbo spin echo (3D-TSE) has been developed for evaluation of carotid artery stent placement. We investigated the use of the 3D-TSE imaging method for the evaluation of intracranial vascular stent placement.Methods: The subjects consisted of nine patients who underwent intracranial vascular stent placement between April 2015 and December 2019. Postoperatively, the lumens of the placed stents were measured by TOF-MRA, DSA, and 3D-TSE imaging. Analysis was performed by type of stent and placement site.Results: The stents used were Neuroform Atlas (3 patients), LVIS (3 patients), LVIS Jr (2 patients), and Integrity (1 patient). TOF-MRA of the stent placement site showed defects in the image or poor visualization in all nine patients, whereas 3D-TSE imaging visualized the lumen at the stent indwelling site in all patients. The blood vessel diameter measured by the DSA and 3D-TSE imaging exhibited positive correlations regardless of the stent type and placement site.Conclusions: 3D-TSE imaging allows visualization of the lumen of the site of an intracranial vascular stent, regardless of the type of stent or the vessel. Thus, this method may be useful for evaluating the vascular lumen of a lesion.