Abstract
The most important problem in treating the survivors from cerebrovascular accident (CVA) is the rehabilitation of hemiplegia.In the present study, the relationships of the findings in cerebral angiography (CAG) to the effect of rehabilitation were investigated using 92 patients of postapoplectic hemiplegia: 69cerebral infarction, 21 cerebral hemorrhage and2subarachnoid hemorrhage. The diagnosis was made according to the criteria proposed by the research group supported by the Ministry of Education. The CAG findings were classified into the following categories: stenosis, occlusion, elongation, and tortuosity.In order to evaluate the results of rehabilitation, following classification was used: 4 stages for the function of upper extremities (non-functioning, aided, subnormally and normally working hand), 5stages for the function of lower extremities (bedridden, not walking, assisted walking, independent but incomplete walking, and independent walking) and4stages for activities of daily living (ADL)(totally dependent, partially dependent, partially independent and independent). Evaluation of the degree was made at the times of admission and discharge.The improvement of upper and lower extremities and ADL was observed in 28.2%, 71.6% and 61.2% of the cases, respectively. In either of cerebral infarction and hemorrhage the improvement of the function of lower extremities and ADL was observed significanly more frequently than that of upper extremities.Function of lower extremities was improved in significantly more cases of cerebral hemorrhage than cerebral infarction, while no difference was found in upper extremities and ADL. Patients with cerebral infarction having occlusion or marked stenosis showed much lower incidence of improvement of upper extremities than those without marked stenosis. In cases with lesions in all 3 vessels of internal carotid, anterior cerebral and middle cerebral arteries the improvement was not always inferior to those with one or 2 vessel lesions.The visibility of the lenticulostriate arteries was not related to the outcome of abilitation.The patients who began rehabilitation within three months after the attack showed significantly better improvement than those who began rehabilitation later.From above findings it is concluded that CAG is a very useful indicator to predict the potentiality of the rehabilitation.Key words: cerebrovascular accident, cerebral angiography, rehabilitation, hemiplegia, prognosis
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