Right Brain Stroke Syndromes

Thomas, Jonathan Oen; Barrett, Anna M.

doi:10.1016/b978-0-323-55381-0.00005-6

Cited by 5 publications

(4 citation statements)

References 154 publications

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“…Spatial neglect is described as failure to orient, perceive, and/or respond to left space after a right brain stroke, which is accompanied by functional disability and is usually under-recognized [116]. This condition is particularly important for stroke recovery given the challenges such as prolonged hospitalization, requiring more caregiver/supervision, poor motor recovery, and increased fall risk.…”

Section: Prism Adaptation Therapymentioning

confidence: 99%

Advances in Stroke Neurorehabilitation

Gunduz,

Bucak,

Keser

2023

JCM

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Stroke is one of the leading causes of disability worldwide despite recent advances in hyperacute interventions to lessen the initial impact of stroke. Stroke recovery therapies are crucial in reducing the long-term disability burden after stroke. Stroke recovery treatment options have rapidly expanded within the last decade, and we are in the dawn of an exciting era of multimodal therapeutic approaches to improve post-stroke recovery. In this narrative review, we highlighted various promising advances in treatment and technologies targeting stroke rehabilitation, including activity-based therapies, non-invasive and minimally invasive brain stimulation techniques, robotics-assisted therapies, brain–computer interfaces, pharmacological treatments, and cognitive therapies. These new therapies are targeted to enhance neural plasticity as well as provide an adequate dose of rehabilitation and improve adherence and participation. Novel activity-based therapies and telerehabilitation are promising tools to improve accessibility and provide adequate dosing. Multidisciplinary treatment models are crucial for post-stroke neurorehabilitation, and further adjuvant treatments with brain stimulation techniques and pharmacological agents should be considered to maximize the recovery. Among many challenges in the field, the heterogeneity of patients included in the study and the mixed methodologies and results across small-scale studies are the cardinal ones. Biomarker-driven individualized approaches will move the field forward, and so will large-scale clinical trials with a well-targeted patient population.

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Section: Prism Adaptation Therapymentioning

confidence: 99%

Advances in Stroke Neurorehabilitation

Gunduz,

Bucak,

Keser

2023

JCM

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“…Hemineglect is a complex disabling disorder commonly following a right-sided hemispheric stroke [1]. It is commonly caused by large strokes in the territory of the middle cerebral, particularly those affecting the temporo-parieto-occipital area [2].…”

Section: Introductionmentioning

confidence: 99%

Effect of vestibular rehabilitation therapy on spatio-temporal gait parameters in elderly patients with post-stroke hemineglect

Elhamrawy¹,

Mohamed²,

Bahnasy³

et al. 2021

areh

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Introduction: Hemineglect is a lack of awareness for the contralesional space. It is a complex neurologic condition to rehabilitate. The study was designed to investigate the effects of vestibular rehabilitation therapy (VRT) on spatio-temporal gait parameters in hemineglect.Material and methods: Thirty-two hemineglect patients were randomly assigned to the experimental and the control group. The experimental group received 60 minutes of training (4 days/week) for the first four weeks (40 minutes traditional physiotherapy and 20 minutes VRT) and then completed the following four weeks with 60 minutes of only traditional physiotherapy. For eight weeks, the control group completed 60 minutes of the traditional program four days a week. The Microsoft Kinect V2 was used to measure spatio-temporal gait parameters. Patients were assessed at baseline, four and eight weeks post-intervention.Results: After four and eight weeks of intervention, the experimental group demonstrated a significant improvement in walking speed (P = 0.0002, d = 12.38 and P = 0.001, d = 13.69, respectively), cadence (P = 0.0003, d = 3.88, and P = 0.0003, d = 5.19, respectively), paretic step length (P = 0.0001, d = 2.53, and P = 0.001, d = 3.84, respectively), and non-paretic step length (P = 0.0119, d = 2.06, and P = 0.0044, d = 2.31, respectively). There were no significant differences in the control group in any of the spatio-temporal gait parameters.Conclusions: VRT improves the spatio-temporal gait parameters in hemineglect, allowing patients to walk more securely and navigate more easily during walking. VRT might improve the patients' postural control, weight distribution, and orientation during walking. This improvement was maintained following training, and additional improvements in spatio-temporal gait parameters were observed compared to baseline.

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“…Thus, clinical practice guidelines for the assessment and treatment of spatial neglect are only available for stroke care 19 . People with anosognosia may be pathologically unaware of several different kinds of deficits; however, anosognosia for left body paralysis is very strongly associated with right brain injury 20 . Although rehabilitation approaches for anosognosia are not as well-researched as those for spatial neglect, evidence shows they may improve deficits and so this article describes how these treatments can be used.…”

Section: Introductionmentioning

confidence: 99%

“…19 People with anosognosia may be pathologically unaware of several different kinds of deficits; however, anosognosia for left body paralysis is very strongly associated with right brain injury. 20 Although rehabilitation approaches for anosognosia are not as well-researched as those for spatial neglect, evidence shows they may improve deficits and so this article describes how these treatments can be used. Neurologists need to advocate for patients with right brain syndromes to ensure quality care and good outcomes.…”

Section: Introductionmentioning

confidence: 99%

Spatial Neglect and Anosognosia After Right Brain Stroke

Barrett¹

2021

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW Up to 80% of survivors of right brain stroke leave acute care without being diagnosed with a major invisible disability. Studies indicate that a generic cognitive neurologic evaluation does not reliably detect spatial neglect, nor does it identify unawareness of deficit after right brain stroke; this article reviews the symptoms, clinical presentation, and management of these two cognitive disorders occurring after right brain stroke. RECENT FINDINGS Stroke and occupational therapy practice guidelines stress a quality standard for spatial neglect assessment and treatment to reduce adverse outcomes for patients, their families, and society. Neurologists may attribute poor outcomes associated with spatial neglect to stroke severity. However, people with spatial neglect are half as likely to return to home and community, have one-third the community mobility, and require 3 times as much caregiver supervision compared with similar stroke survivors. Multiple randomized trials support a feasible first-line rehabilitation approach for spatial neglect: prism adaptation therapy; more than 20 studies reported that this treatment improves daily life independence. Evidence-based treatment of anosognosia is not as developed; however, treatment for this problem is also available. SUMMARY This article guides neurologists’ assessment of right brain cognitive disorders and describes how to efficiently assemble and direct a treatment team to address spatial neglect and unawareness of deficit.

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Right Brain Stroke Syndromes

Cited by 5 publications

References 154 publications

Advances in Stroke Neurorehabilitation

Advances in Stroke Neurorehabilitation

Effect of vestibular rehabilitation therapy on spatio-temporal gait parameters in elderly patients with post-stroke hemineglect

Spatial Neglect and Anosognosia After Right Brain Stroke

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