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A nontraumatic spinal cord injury related to surfing is called surfer's myelopathy. The case of a 26-yr-old man who became paraplegic after surfing without apparent traumatic events is described. Physical examination revealed a spinal cord injury at T12 according to the American Spinal Injury Association Impairment Scale A. The initial magnetic resonance image revealed a fusiform swelling of the spinal cord from T7-8 to the conus, which was hyperintense on T2-weighted images. After 6 mos of rehabilitation, the patient was followed for more than 1 yr after onset. He became able to walk with knee-ankle-foot-orthoses without assistance. A magnetic resonance image obtained 1 yr after the onset of paraplegia showed an atrophic spinal cord from T7-8 to the conus. The course of the neurologic findings and the imaging studies suggest that the pathogenesis of surfer's myelopathy may be ischemia of the anterior spinal artery territory induced by the abnormal trunk posture while surfing.

Falls and their consequences, including fear and activity restriction, 1 are major health care problems affecting the quality of life among older adults. 2 With advanced age, postural balance and gait functions develop limitations, and these impairments are consistently linked with falls. 3,4 For a fall to occur, an individual must first experience loss of balance and then subsequently be unable to recover. Therefore, to prevent falls, it is necessary to not only maintain stability during a voluntary movement but also effectively respond to and recover from the loss of balance. In particular, the protective stepping response to laterally oriented perturbations is of clinical importance because the lateral balance recovery performance through the stepping response is a predictor of the risk of falling, 5,6 and lateral falls are a leading cause of severe injuries such as hip fractures. 7 Aging individuals reportedly have a decreased threshold of single-step lateral balance recovery, 8 requiring more steps and arm reactions compared with younger adults. 6,9,10 Moreover, aging changes in lateral balance recovery include step types; younger adults frequently perform lateral step with passively loaded limb. 5 In contrast, older adults commonly use either crossover step with unloaded limb or, especially if they have a history of falls, a medial step with the passively unloaded limb. 5 The cause of balance dysfunction has been examined considering aging perturbation training might lead to improved ability to recover from balance loss.

Bilateral lesions damaging the primary auditory cortex or the auditory radiation may cause auditory agnosia. We describe a 67-year-old woman with auditory agnosia after bilateral thalamic hemorrhage. Initially, she showed subcortical deafness for words and environmental sounds. Pure tone audiometry showed a moderate-to-severe hearing loss mean hearing level, right 56 dB ; left 57 dB , while the recording of auditory brainstem response was normal. Brain CT demonstrated a hematoma in the left thalamus and a narrow low density area suggesting a sequel of the right thalamic hemorrhage. Hearing training was begun using sound sources that were easily recognizable for the patient. Her recognition was better for words than for individual Japanese vowel or consonant-vowel sounds, and the use of lip reading contributed to her better recognition of words. After 2 months, she was able to communicate with medical staff and family members in daily conversation. Jpn J Rehabil Med .

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