Useless, useless, useless. You mean that you missed the Margaret
Yekutiel book about this from 2001, 'Sensory Re-Education of the Hand
After Stroke'? And still didn't write a protocol on how to fix this?
How long do stroke survivors have to put up with such fucking
incompetency?
Time Course and Association With Infarct Location
Abstract
Background and Purpose—
About
50% to 80% of stroke survivors present with somatosensory deficits.
Somatosensory deficits because of an ischemic stroke are determined by
the infarct location. However, a detailed understanding of the long-term
effect of lesions on somatosensory performance is lacking.
Methods—
This
prospective observational study enrolled 101 ischemic stroke patients.
For voxel-based lesion-symptom mapping, magnetic resonance imaging
fluid-attenuated inversion recovery imaging infarct lesions were
segmented within 5 days after stroke. Standardized tests such as the
National Institutes of Health Stroke Scale and the Rivermead Assessment
of Somatosensory Performance were performed during acute stage, after 3
and 12 months. This included bilateral testing for multiple tactile and
proprioceptive somatosensory modalities (pressure, light touch,
sharp-dull discrimination, temperature discrimination, sensory
extinction, 2-point discrimination, and joint position and movement
sense). We further study the association of acute somatosensory deficit
with functional outcome 12 months after stroke assessed by the modified
Rankin Scale using univariate and multiple linear regression analysis
also including acute motor deficit assessed by the arm research action
test.
Results—
Sixty
patients (59.4%) showed impairment in at least one somatosensory
modality. Light touch was most frequently affected (38.7%), whereas
temperature was least frequently affected (21.8%). After 3 months,
significant recovery was observed in all somatosensory modalities, with
only minor additional improvements after 12 months. Voxel-based
lesion-symptom mapping revealed significant associations of lesions in
the primary and secondary somatosensory and insular cortex with
somatosensory deficits. Acute somatosensory deficit was associated with
functional outcome at 12 months. However, including the acute motor
deficit, somatosensory deficit was no longer an independent predictor of
functional outcome.
Conclusions—
Our
study confirms that somatosensory deficits are frequent in acute
ischemic stroke but largely recover over time. Infarct lesions in the
primary and secondary somatosensory cortex and insula show a robust
association with somatosensory impairment. Long-term disability is
influenced by somatosensory deficits but driven by motor symptoms.(Where the fuck is the protocol that will cure these deficits?)
Footnotes
Correspondence
to Simon S. Kessner, MD, Department of Neurology, University Medical
Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg. Email
s.kessner@uke.de
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