Cerebral Apoplexy and its Rehabilitation in Rural Districts

Abstract

Cerebral apoplexy in rural districts is in many cases caused by cerebral hemorrhage and occurs frequently in younger persons. However, according to recent statistics of mortality, cerebral hemorrhage is decreasing but cerebral infarction is increasing, similar to other districts. Seeing from the disease types obtained from our 182 dissected subjects in these 6 years (the dissection ratio, 78%), the ratio of cerebral hemorrhage vs. cerebral infarction was 2.2 in the early half period but it became 1.1 in the late half, and cerebral hemorrhage decreased. However, seeing from the disease types of 670 in-patients in an acute stage, cerebral infarction is not always increasing, but the ratio of the infarction in those older than 60 years old raised from 49% to 71%. It is noticed that cerebral hemorrhage is not always decreasing in those younger than 40 years old. In cerebral infarction the occlusion of main arteries increases recently to 34% from 6%, and it presents a problem in the view of rehabilitation. The rehabilitation goal was researched in 430 subjects based on the type of disease: 77% of cerebral hemorrhage and 90% of cerebral infarction got the goal in the independent group: the former was inferior in this aspect. As to the patients of infarction, the goal was got in 33% of embolism in main artery occlusion in the independent group, in 67% of thrombosis and in 91% of the subjects having no main artery occlusion. The pregnosis of the embolic artery occlusion is unsatisfactory.The effect of adrenocortex hormones was studied as to 166 cases in the acute stage of cerebral hemorrhage: it could improve the survival pregnosis within 1 month but could not improve the rehabilitation goal ratio.The relapsed subjects admitted by the hospital for rehabilitation were pursued and the index for forecasting the prognosis (22 points being the full mark) was set: the relapse ratio was 3% in the subjects with less than 10 points and 26% with more than 11 points; the index was found to be effective in the internal check. 46 bodies were subjected to autopsy for the external check: the relapse was 0% with less than 10 points, 24% with more than 11 points and 71% with more than 15 points, and the index was found to be effective.The patients of cerebral apoplexy who had been discharged from the hospital were followed up: 4% of them returned to their agricultural life and 13% returned to the non-agricultural occupation. The recovery ratio in the agricultural field was lower.Besides what described above, the relation between the Rossolimo's reflex and the rehabilitation and the prognosis research on subarachnoidal hemorrhage were discussed.