| Posterior thalamic hemorrhage induces "pusher syndrome". | |
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MedLine Citation:
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PMID: 15781819 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Recent findings argue for a pathway in humans for sensing the orientation of gravity and controlling upright body posture, separate from the one for orientation perception of the visual world. Stroke patients with contraversive pushing were shown to experience their body as oriented upright when actually tilted about 20 degrees to the ipsilesional side, in spite of normal visual-vestibular functioning. A recent study suggested the involvement of posterolateral thalamus typically associated with the disorder. OBJECTIVE: To evaluate the relationship between pushing behavior and thalamic function. METHODS: Over a 3-year period the authors prospectively investigated 40 patients with left- or right-sided thalamic strokes. RESULTS: Twenty-eight percent showed contraversive pushing. The authors found a strong relationship between etiology, vascular territory, lesion size, and neurologic disorders associated with contraversive pushing. Pusher patients had larger lesions that typically were caused by hemorrhage (vs infarcts) located in the posterior thalamus (vs anterior thalamic lesions in those patients without pushing behavior). A paresis of the contralesional extremities was more frequent and more severe in pusher patients. Further, these patients showed more additional spatial neglect with right thalamic lesions, while they tended to be more aphasic with left thalamic lesions. CONCLUSIONS: Posterior thalamus seems to be fundamentally involved in our control of upright body posture. Higher pressure, swelling, and other secondary pathologic processes associated with posterior thalamic hemorrhage (vs thalamic infarction) may provoke contraversive pushing in combination with additional neurologic symptoms. |
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Authors:
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Hans-Otto Karnath; Leif Johannsen; Doris Broetz; Wilhelm Küker |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurology Volume: 64 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-03-22 Completed Date: 2006-02-22 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 1014-9 Citation Subset: AIM; IM |
Affiliation:
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Section Neuropsychology, Department of Cognitive Neurology, Hertie-Institute for Clinical Brain Research, Tübingen, Germany. Karnath@uni-tuebingen.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Arm / innervation, physiopathology Brain Infarction / pathology, physiopathology, radiography Brain Mapping Female Functional Laterality / physiology Humans Intracranial Hemorrhages / complications*, diagnosis Leg / innervation, physiopathology Magnetic Resonance Imaging Male Middle Aged Movement Disorders / diagnosis, etiology*, physiopathology* Neural Pathways / physiopathology Orientation / physiology Paresis / diagnosis, etiology, physiopathology Posterior Thalamic Nuclei / pathology, physiopathology*, radiography Postural Balance / physiology Prospective Studies Thalamic Diseases / diagnosis, physiopathology* Tomography, X-Ray Computed |
| Comments/Corrections | |
Comment In:
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Neurology. 2005 Nov 22;65(10):1682; author reply 1682
[PMID:
16301515
]
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Erratum In:
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Neurology. 2005 Sep 27;65(6):819 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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