Abstract

Objective: Unilateral stroke can lead to a disorder of postural balance that manifests as a pushing toward the paretic side, termed "pusher syndrome" (PS). The relationship between lesion location and the time course of recovery of PS is still unclear. Thus, this study investigated the relationship between the time course of PS and lesion sites. Methods: We investigated nine patients with acute ischemic stroke in the right hemisphere of the brain. The time course of the severity of PS was assessed using the standardized Scale for Contraversive Pushing. Patients were divided into two groups: the recovery and no recovery groups. Magnetic resonance imaging data were obtained to assess the effect of ischemic lesion sites on the recovery of PS and was analyzed with lesion subtraction technique. Results: The subtraction imaging revealed an association between delay in the recovery of PS and frontal white matter lesions. These regions corresponded to the cortico-spinal tract and superior longitudinal fasciculus. Conclusions: Previous studies revealed that patients with PS required longer rehabilitation to reach outcome goals than patients without PS. Our results indicate that when patients with PS have right frontal white matter lesions, planning a long rehabilitation should be considered compared with patients with other lesions.

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