Síndrome de pusher em pacientes com avc e sua associação com gravidade clínica e dependência funcional

Abstract

Objective. To establish the prevalence of pusher syndrome (PS) in patients after stroke from clinical criteria contained in Scale for Contraversive Pushing (CPS - evaluation of the symptom of pushing), and correlate them with neurological abnormalities, severity of stroke and functionality. Method. a cross-sectional study with convenience sample of patients of both sexes with a diagnosis of acute stroke. We included clinically stable patients and that were able to assess the severity of the event from the range of National Institute of Health Stroke Scale (NIHSS) and BI. To diagnose the pusher syndrome we used two scoring criteria with different cutoff points in the Scale for Contraversive Pushing: result greater than or equal to 1 (criterion I) or greater than zero (criterion II). Results. 86 patients were evaluated. Mean NIHSS and Barthel index were 8.5 and 48,8 points respectively. The presence of PS 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). Conclusion. The prevalence of PS 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.