脑卒中后进行性运动障碍和精神病:一例报告。

Grace Small
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引用次数: 2

摘要

中风后神经功能缺损极为常见。大多数患者在中风后会出现构音障碍、失语、面部无力和上肢和下肢无力(Yanagida, Fujimoto, Inoue, & Suzuki, 2015)。面部偏瘫、手臂运动无力、口齿不清或说话奇怪都是中风的警告信号,提醒患者需要紧急治疗(National Heart, Lung, and Blood Institute, 2014)。快速治疗允许脑组织更快的再灌注,限制对大脑的损伤量和患者经历的缺陷的严重程度。中风引起的神经功能障碍通常在血管堵塞或出血后几分钟出现;然而,缺血可在梗死后持续发展数天(National Heart, Lung, and Blood Institute, 2014)。迟发性运动缺陷或进行性运动缺陷(PMD)在中风后几年发展相对罕见的文献。一个值得注意的案例研究讨论了延迟的神经系统恶化,包括在脑桥出血几个月后构音障碍和共济失调的恶化(Menezes Cordeiro, Tavares,Reim,o, Geraldes, & Ferro, 2013)。这一进展归因于脑桥区域肥大面积的增加,磁共振成像(MRI)对比证实了这一点(Menezes Cordeiro等人,2013)。然而,研究表明,中风幸存者通常会经历精神健康障碍,如抑郁和焦虑;事实上,多达三分之一的幸存者最终被诊断出患有这种疾病(Hackett, Yapa, Parag, & Anderson, 2005)。其他精神疾病,如妄想和幻觉,在文献中没有很好的记录。本文的目的是为了更好地了解中风幸存者的迟发性运动和心理障碍。
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Progressive Motor Deficits and Psychosis After Stroke: A Case Presentation.
N eurological deficits after a stroke are extremely common. Most patents experience dysarthria, aphasia, facial weakness, and weakness of upper and lower limbs after a stroke (Yanagida, Fujimoto, Inoue, & Suzuki, 2015). Facial hemiparesis, motor weakness of arms, and slurred or strange speech are associated as warning signs of stroke and signal the patient that urgent treatment is needed (National Heart, Lung, and Blood Institute, 2014). Fast treatment allows for quicker reperfusion of the brain tissue, limiting the amount of damage to the brain and the severity of the deficits experienced by the patient. The onset of neurological deficits from stroke is often several minutes after blockage or hemorrhage; however, deficits can continue to develop for up to several days after infarct (National Heart, Lung, and Blood Institute, 2014). Delayed motor deficits or progressive motor deficits (PMD) that develop several years after stroke are relatively rare in the literature. One notable case study discusses delayed neurological deterioration including worsening of dysarthria and ataxia several months after pontine hemorrhage (Menezes Cordeiro, Tavares,Reim,o, Geraldes, & Ferro, 2013). This progression was attributed to an increase in the area of hypertrophy in the pontine region, confirmedwithmagnetic resonance imaging (MRI) comparison (Menezes Cordeiro et al., 2013). However, research has shown that it is common for survivors of stroke to experience mental health disorders such as depression and anxiety; in fact, up to a third of survivors are eventually diagnosed with such disorders (Hackett, Yapa, Parag, & Anderson, 2005). Other mental health disorders such as delusions and hallucinations are not well documented in the literature. The purpose of this article is to gain a better understanding of delayed motor and psychological disorders in a stroke survivor.
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Implementation of a Nurse-Initiated Protocol to Improve Enteral Medication Administration Documentation in Stroke Patients. Methods for Developing Neuroscience Nursing Clinical Practice Guidelines. Development of an Acute Stroke Care Seeking Framework. Exploring Perspectives on Stroke Standard Set Data Collection: A Qualitative Descriptive Study. Measures and Influencers of Reintegration for the Stroke Patient: A Systematic Review.
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