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RISS 인기검색어
- 검색키워드
- 저자 : Kenneth M Heilman, (검색결과 3 건)
- 무료
- 기관 내 무료
- 유료
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Hemispheric Differences in Ischemic Stroke: Is Left-Hemisphere Stroke More Common?
Vishnumurthy Shushrutha Hedna,Aakash N Bodhit,Saeed Ansari,Adam D Falchook,Latha Stead,Kenneth M Heilman,,Michael F Waters 대한신경과학회 2013 Journal of Clinical Neurology Vol.9 No.2
Background and Purpose Understanding the mechanisms underlying stroke can aid the development of therapies and improve the final outcome. The purposes of this study were to establish whether there are characteristic mechanistic differences in the frequency, severity, functional outcome, and mortality between left- and right-hemisphere ischemic stroke and, given the velocity differences in the carotid circulation and direct branching of the left common carotid artery from the aorta, whether large-vessel ischemia (including cardioembolism) is more common in the territory of the left middle cerebral artery. Methods Trial cohorts were combined into a data set of 476 samples. Using Trial of Org 10172 in Acute Stroke Treatment criteria, ischemic strokes in a total 317 patients were included in the analysis. Hemorrhagic stroke, stroke of undetermined etiology, cryptogenic stroke, and bilateral ischemic strokes were excluded. Laterality and vascular distribution were correlated with outcomes using a logistic regression model. The etiologies of the large-vessel strokes were atherosclerosis and cardioembolism. Results The overall event frequency, mortality, National Institutes of Health Stroke Scale (NIHSS)score, Glasgow Coma Scale score, and rate of mechanical thrombectomy interventions differed significantly between the hemispheres. Left-hemispheric strokes (54%) were more common than right-hemispheric strokes (46%; p=0.0073), and had higher admission NIHSS scores (p=0.011),increased mortality (p=0.0339), and higher endovascular intervention rates (p≤0.0001). ischemic strokes were more frequent in the distribution of the left middle cerebral artery (122 vs. 97;p=0.0003) due to the higher incidence of large-vessel ischemic stroke in this area (p=0.0011). Conclusions Left-hemispheric ischemic strokes appear to be more frequent and often have a worse outcome than their right-hemispheric counterparts. The incidence of large-vessel ischemic strokes is higher in the left middle cerebral artery distribution, contributing to these hemispheric differences. The hemispheric differences exhibit a nonsignificant trend when strokes in the middle cerebral artery distribution are excluded from the analysis.
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Park, Key Chung,Jeong, Yong,Lee, Byung Hwa,Kim, Eun-Joo,Kim, Gyung Moon,Heilman, Kenneth,Na, Duk Psychology Press, part of the Taylor Francis Group 2005 Neurocase Vol.11 No.5
<P>Damage to the left occipital lobe and the splenium or forceps major is often associated with pure alexia, thought to be an occipital-temporoparietal disconnection syndrome. A patient with the parallel lesion, a combined right occipital and splenial lesion, showed severe left-sided visual spatial neglect, but no significant neglect in other sensory modalities. This visual neglect might be related to a disconnection between the visual information processed by the left occipital lobe and the right posterior temporal-inferior parietal areas that mediate attention in the left hemispace.</P>
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Consecutive Versus Return Motor Perseveration During Line Cancellation Task in Hemispatial Neglect
Kim, Eun-Joo,Lee, Byung Hwa,Park, Key Chung,Suh, Mee Kyung,Ku, Bon D.,Heilman, Kenneth M.,Na, Duk L. Lippincott Williams Wilkins, Inc. 2009 COGNITIVE AND BEHAVIORAL NEUROLOGY Vol.22 No.2
BACKGROUND: Patients with neglect often repeatedly cancel the same targets, a form of motor perseveration (MP). There seems to be 2 types of MP, making uninterrupted multiple strokes for each target, consecutive MP (CMP) or return MP (RMP) where patients return to previously canceled targets and remark them. OBJECTIVE: The purpose of this study is to learn whether these 2 forms of MP are dissociable. METHODS: We studied 3 patients, 1 with primarily CMP, another with primarily RMP and a third with mixed CMP and RMP by having them perform the cancellation task with and without background movement. RESULTS: In the patient with primarily RMPs (patient 1), leftward background movement decreased the severity of the neglect and the perseveration. Rightward background movement increased both. In contrast to patient 1, who showed the correspondence between the severity of neglect and perseveration, the patient with both CMP and RMP (patient 2) and the patient with primarily CMPs (patient 3) did not show such correspondence. CONCLUSIONS: The different responses of CMP and RMP to the treatment of neglect suggest that different mechanisms account for these 2 forms of MP. Although RMP might be related to neglect induced aberrant approach behaviors, CMP seems to be related to a disengagement disorder.
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