Brain Neurorehabil.  2010 Mar;3(1):42-49. 10.12786/bn.2010.3.1.42.

The Relationship between Hand Function and Brain Lesion at Acute Stroke Patients: A Pilot Study

Affiliations
  • 1Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Korea. msdykim@hanafos.com

Abstract

OBJECTIVE: To determine the relationship of hand motor function recovery and Tatu's vascular territory classification of brain lesion in acute stroke. METHOD: Thirty one patients with acute cerebral infarct were included. We divided them into two groups. One had cerebral lesions supplied by the leptomeningeal branches of cerebral artery and the other by the perforating branches of cerebral artery. The leptomeningeal group was subdivided into middle cerebral artery group (LMCA) and posterior cerebral artery group (LPCA). The perforating group was again divided by perforating branch of the middle cerebral artery group (PMCA) and anterior choroidal artery group (PACoA). The diffusion weighted magnetic resonance image was used as a reference image. The hand motor recovery was scored by physical examination at admission and discharge. Score 0 was for no motion, 1 was for synergy movement, and 2 was for isolated hand movement.
RESULTS
Eight patients were in LMCA group, while 3 were in LPCA group. Eight were in PMCA group, and twelve patients were in PACoA group. The distribution of the hand motor recovery at admission was score 0 (3,1,5,8, for LMCA, LPCA, PMCA, PACoA), 1 (2,1,1,4) and 2 (3,1,2,0), while at discharge, score 0 (3,0,4,4), 1 (0,0,1,5) and 2 (5,3,3,3). Hand functions significantly improved at discharge compared with those at admission in all groups. Especially in PACoA group, the significant better recovery at discharge was achieved.(p<0.05) Isolated hand movement at discharge was significantly better at the leptomeningeal group than perforating group.(p<0.05).
CONCLUSION
Tatu's atlas may be helpful to predict the recovery of hand function for initial assessment of stroke rehabilitation.

Keyword

hand motor function; stroke; tatu's atlas; vascular territory
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