Prevalência da Síndrome de Pusher em pacientes com acidente vascular cerebral e sua associação com gravidade clínica e dependência funcional

Abstract

BACKGROUND: The prevalence of the pusher syndrome can affect patients' motor recovery after stroke (CVA). OBJECTIVES: To establish the prevalence of pusher syndrome in patients after stroke from clinical criteria contained in Contraversive Pushing Scale (evaluation of the symptom of pushing), and correlate them with neurological abnormalities, severity of stroke and functionality. METHODS: a cross-sectional study with convenience sample of patients of both sexes with a diagnosis of acute stroke. We included patients with clinically stable and able to assess the severity of the event from the range of NIHSS, Barthel (evaluation of the symptom of pushing). To diagnose the pusher syndrome used two scoring criteria with different cutoff points, pushing the Contraversive scale: result greater than or equal to 1 (criterion I) or greater than zero (criterion II).RESULTS: 86 patients were evaluated. Of these 30 met the inclusion criteria. 17 were men with mean age of 52.3 years. 26 patients had ischemic stroke and hemorrhagic stroke four. 14 had hemiplegia on the left and 16 right. Mean NIHSS and Barthel index were 8.5 and 48.8 points respectively. Using the criteria I and II prevalence rates were 3.3% and 26.6% respectively. The presence of pusher syndrome was significantly associated with lower values when the Barthel scale, we used the criterion II (22.5 ± 8.5 versus 58.4 ± 27.3, P <0.001). CONCLUSIONS: The prevalence of pusher syndrome in patients after acute stroke is significant and can vary according to the criteria used. Its presence is associated with clinical severity and functional dependence, higher incidence in ischemic stroke event, parietal lobe and middle cerebral artery, respectively.