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脑出血患者步态功能恢复延迟。

Delayed recovery of gait function in a patient with intracerebral haemorrhage.

机构信息

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Korea.

出版信息

J Rehabil Med. 2012 Apr;44(4):378-80. doi: 10.2340/16501977-0962.

Abstract

OBJECTIVE

We report here on a patient with intracerebral haemorrhage (ICH), who showed unusually delayed motor recovery of the leg, which started at 6 months after ICH onset.

CASE REPORT

A 53-year-old man underwent craniotomy and drainage for a right putaminal ICH. The patient presented with complete paralysis of the left extremities at ICH onset. Despite having undergone rehabilitation starting at 7 weeks after onset, the patient did not show significant motor recovery of the left extremities until 6 months after onset, when the affected left leg began to show motor recovery to the point that he was able to extend his hip and knee without gravity 7 months after onset. As a result, he was able to walk independently on an even floor 9 months after onset.

RESULTS

On 6-month diffusion tensor tractography, the right corticospinal tract showed disruption with Wallerian degeneration to the pontomedullary junction.

CONCLUSION

This case study highlights the extensive potential for the human brain to aid in the recovery of walking after injury. In conclusion, clinicians should attempt to determine the causes of difficulty walking when examining patients with ICH and then perform intensive rehabilitation for the recovery of walking.

摘要

目的

我们在此报告一例脑出血(ICH)患者,其腿部运动恢复异常延迟,始于 ICH 发病后 6 个月。

病例报告

一名 53 岁男性因右侧豆状核 ICH 行开颅手术和引流术。ICH 发病时,患者左侧肢体完全瘫痪。尽管在发病后 7 周开始进行康复治疗,但患者左侧肢体的运动恢复并不明显,直到发病后 6 个月,患侧左腿开始出现运动恢复,以至于他能够在发病后 7 个月无重力伸展髋关节和膝关节。因此,他在发病后 9 个月能够在平坦的地面上独立行走。

结果

在发病后 6 个月的弥散张量追踪中,右侧皮质脊髓束显示中断,伴有至桥延髓交界处的沃勒变性。

结论

本病例研究强调了大脑在受伤后帮助恢复行走方面的巨大潜力。总之,当检查 ICH 患者时,临床医生应尝试确定行走困难的原因,然后进行密集康复以恢复行走。

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