No abstract available.
Diagnosis* ; Heat Stroke* ; Hot Temperature*

Post-stroke movement disorders are uncommon, but comprise an important part of secondary movement disorders. These exert variable and heterogeneous clinical courses according to the stroke lesion and its temporal relationships. Moreover, the predominant stroke symptoms hinder a proper diagnosis in clinical practice. This article describes the etiology, treatment options and prognosis of post-stroke movement disorders.
Diagnosis ; Movement Disorders* ; Prognosis* ; Stroke

This study was undertaken to evaluate the clinical usefulness of magnetic motor evoked potential (MEP) in the diagnosis of stroke and predicting the motor improvement following stroke. The cortical, cervical and lumbar stimulations were performed in the case of 24 healthy controls and 24 to a target muscle between after transcranial stimulation and after cervical or lumbar stimulation. There was no case showing no response in controls. But in 11 out of 24 ischemic patients, we could not get cortical MEP. Mean CMCT of abductor pollicis brevis muscle was not significantly different in controls and stroke patients in whom MEPs were recorded. There were significant differences between mean CMCT of normal controls and that of stroke patients showing MEPs in AH Muscle. MEP Results from testing the stroke patients were correlated with site of lesion, degree of motor weakness and motor improvement after 1 to 2 months. These results suggest that magnetic MEP is easy and useful in electrophysiological test of central motor pathway and is useful indicator for representing the motor weakness and predicting the motor outcome in acute ischemic stroke patients.
Diagnosis ; Evoked Potentials, Motor* ; Humans ; Stroke*

PURPOSE: Diffusion-weighted MRI (DWI) is well known to be sensitive in the detection of hyperacute infarct, but has not been systematically investigated in patients with acute or subacute infarct. We evaluated the usefulness of diffusion-weighted MRI in assessing the various stages of brain infarct. MATERIALS AND METHODS: Fifty-five consecutive patients with symptoms of brain infarct underwent fast spinecho T2-weighted MRI (T2W1) and DWI. Using only a brief clinical history, two radiologists first attemptelto detect the lesion using T2W1, which was then compared with DWI. The usefulness of the latter was then evaluated in terms of the following criteria: 1) Its abilility to detect a lesion not seen at T2WI (detection); 2) localization of the responsible ischemic focus among multiple high-signal intensities seen at T2WI (localization); 3) conspicuity of a lesion which was subtle at T2WI (conspicuity); 4) detection of multiple lesions (multiplicity). RESULTS: DWI was useful in 44 of 55 patients (80%), including 9 of 9 (100%) with hyperacute infarct (<6 hours), 20 of 27 (74%) with acute infarct (<48 hours), and 15 of 19 (79%) with subacute infarct (<2 weeks). Among the nine patients at the hyperacute stage, DWI was useful for detection of the lesion in six (67%), for localization, 4 (44%) in one (11%), for conspicuity in four (44%), and for multiplicity in five (56%); at the acute stage (20 patients), for detection in three (15%), for localization in ten (50%), for conspicuity in eight (40%), and for moltiplicity in five (25%); and at the subacute stage (15 patients), for detection in three (20%), for localization in nine (60%), for conspicuity in two (13%), and for multiplicity in three (20%). CONCLUSION: DWI is very sensitive for the diagnosis of hyperacute infarct. In the assessment of this, it is useful during the acute or subacute period for the detection of small lesions, the localization of ongoing lesions among multiple high signal intensities seen at T2WI, and the determination of lesion conspicuity.
Brain ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Stroke*

Female ; Humans ; Ossification, Heterotopic ; diagnosis ; Stroke ; complications

Female ; Humans ; Ossification, Heterotopic ; diagnosis ; Stroke ; complications

Hydrocephalus occurs frequently after stroke and has been reported to affect the functional outcome. We investigated 77 stroke patients retrospectively to evaluate whether or not hydrocephalus affects the functional outcome. The patients were divided into three groups: Group 1, 20 patients without hydrocephalus; Group 2, 28 patients with early onset hydrocephalus; Group 3, 29 patients with delayed onset hydrocephalus. Functional status was evaluated by 3 functional indices, Mini-Mental Status Examination(MMSE), Barthel index, and PULSES profile. These 3 functional indices were compared between pre- and post-rehabilitation stages in Groups 1 and 2, and compared among pre-rehabilitation, post-hydrocephalus, and post-rehabilitation stages in Group 3. Significant functional improvements were shown in the post-rehabilitation stage in Groups 1 and 2 (P<0.05). In Group 3, the functional improvements were shown in the post-rehabilitation stage when compared to the pre-rehabilitation stage, but without statistical significance. However, significant functional improvements were demonstrated in the post-rehabilitation stage compared to the post-hydrocephalus stage in Group 3 (P<0.05). In comparing the three groups, the final functional outcome was found to be best in Group 1 and worst in Group 3. We suggest that the time from the onset of hydrocephalus to diagnosis and management is more important than the presence of hydrocephalus itself in the stroke patient in respect to functional outcome.
Diagnosis ; Humans ; Hydrocephalus* ; Retrospective Studies ; Stroke*

OBJECTIVE: To evaluate usefulness of uptake ratio of three phase bone scintigraphy in assessing the complex regional pain syndrome (CRPS) type I in stroke patients METHOD: Forty three stroke patients were diagnosed as CRPS type I based on their symptoms and confirmed by three phase bone scintigraphy. Uptake ratio was calculated by dividing the radioactivity count on the affected side by that on the unaffected side in each phase. Mean uptake ratio was compared among the groups classified by the clinical diagnosis and by the response to treatment. In addition, uptake ratio was compared before and after treatment. RESULTS: Mean uptake ratio of the wrist in blood pool phase was significantly higher than other parts of the body (p<0.05). However, there was no significant difference among the groups classified by the clinical diagnosis nor by the response to treatment. The changes of uptake ratio were variable after treatment, but only the uptake ratio of the wrist in blood flow phase showed correlation with the degree of swelling. CONCLUSION: Uptake ratio of three phase bone scintigraphy was not correlated with clinical findings.
Diagnosis ; Humans ; Radioactivity ; Radionuclide Imaging* ; Stroke* ; Wrist

BACKGROUND: There are numerous famous epileptics, some of whom are merely rumors or fictional, and many of which have been designated as such without objective considerations. METHODS: Six famous epileptics were selected and investigated in various literature sources from a medical point of view, focusing on peer-reviewed journals, biographies, books, and media. RESULTS: The diagnosis of epilepsy in two leaders prior to the 19th century was uncertain due to the lack of objective evidence. The diagnosis could be established in two artists in the 19th century, while it is certain that two politicians in the 20th century had epilepsy, probably due to stroke. CONCLUSIONS: Retrospective diagnoses of epilepsy require documentation of detailed symptoms and medical records of epilepsy. This retrospective review of the literature can provide a basis for assessing famous historical epileptics.
Diagnosis ; Epilepsy ; Medical Records ; Retrospective Studies ; Stroke

PURPOSE: To correlate the findings of perfusion-weighted imaging (PWI) with clinical outcomes in patients with acute lacunar infarction. MATERIALS AND METHODS: Eleven patients (7 males and 4 females) with acute lacunar infarction who were examined within 50 (mean, 29) hours of the onset of symptoms underwent conventional MRI, diffusion-weighted imaging (DWI) and PWI. Gadolinium (0.2 mmol/kg) was injected at a rate of 2 ml/sec, and PWI was performed using a gradient-echo EPI pulse sequence and the following parameters: TR/TE, 2000/60; flip angle, 90 degree; matrix size, 128X128. Relative cerebral blood volume (rCBV) maps were derived from gadolinium bolus perfusion-weighted images where rCBV ratios between infarcted areas were detected by DWI, and contralateral control areas were obtained. In each case, the resulting rCBV ratio at a lesion site was compared with the clinical outcome determined on the basis of the difference between National Institute Health Stroke Scale (NIHSS) scores at admission and discharge. RESULTS: With the aid of the time-intensity curve obtained at PWI, the rCBV maps revealed a hypoperfused area in 10 of 11 patients, and there was positive correlation (r=0.81) with clinical outcome. CONCLUSION: Although PWI has a lower detection rate than DWI, it may be a useful modality for helping determine prognosis in cases of acute lacunar infarction.
Blood Volume ; Diagnosis* ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Male ; Perfusion* ; Prognosis ; Stroke ; Stroke, Lacunar*