Pusher syndrome after cerebrovascular accident: a case report
DOI:
https://doi.org/10.11606/issn.2317-0190.v15i3a102951Keywords:
Stroke, Paresis, Perceptual Disorders, RehabilitationAbstract
Pusher syndrome is a disorder of balance in patients with brain injury. Aim: to report the case of a patient with hemiparesis after thalamic stroke and clinical signs suggesting Pusher Syndrome to promote a discussion about the etiology, pathophysiology, prognosis and clinical evolution of this syndrome for neurologic impaired patients. Method: Retrospective evaluation of a female inpatient aged 62 who developed mild hemiparesis and severe contraversive pushing behavior after acute hemorrhage affecting the right thalamus with NIHSS = 13, FIM = 56 and clinical signs of Pusher Syndrome. Following standard motor physiotherapy and architectonic adaptations, the pushing behavior completely resolved 4 months after the onset with a FIM of 99 although, at that time, left hemiparesis was still present. This case report illustrates that pushing behavior itself may be severely incapacitating, may occur with only mild hemiparesis and affected patients may have dramatic functional improvement and delayed hospital delivered and rehabilitation gains. More studies are crucial for better understanding Pusher Syndrome.
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