The present study investigated the extent to which right and left hemisphere stroke patients, within an acute care rehabilitation unit, differ in neuropsychological symptomatology as reported on a self-report instrument.The subjects were 90 patients admitted to an acute care rehabilitation unit within a midwestern hospital. Two groups of 30 were obtained on the basis of stroke location, either right or left hemisphere. In addition, a group of 30 orthopedic patients were selected to serve as a comparison group.Data was collected using the Neuropsychological Symptom Inventory (Rattan, Dean & Rattan, 1989). A discriminant analysis revealed two discriminant functions which were used to classify group membership. Slightly more than 86% of both left hemisphere stroke patients and orthopedic patients were correctly classified. However, only 46% of right hemisphere stroke patients were accurately predicted. The results clearly support the ability to differentiate the groups and suggest a homogeneous character of the left hemisphere stroke and orthopedic groups. The right hemisphere group appears heterogeneous in make-up. Further statistical analysis revealed no significant difference (a<.05) between stroke groups when examining a factor related to emotional/depression symptoms. However, when stroke patients were compared to orthopedic patients on this factor, a high degree of significance was revealed (p<.001).These results suggest that right hemisphere patients cannot be treated as if they make up a single disorder group within the rehabilitation setting. The use of a self-report measure may prove beneficial with this group is assessing the level of neuropsychological impairment and to make modifications in treatment planning. Additionally, the existence of depression within the stroke group suggest that rehabilitation should focus more on these reactions within the first few weeks post-stroke. / Department of Educational Psychology

Emphasis has always been given to the physiological aspects of stroke. This thesis explores the often neglected psychological areas of stroke. It includes a review of etiology but stress is given to the psychological management of the patient including motivation, aphasia, sensation and perception.The patient's feelings and attitudes and their effects on his recovery are discussed. The way in which the patient interacts with the medical staff, his friends and family markedly affect his eventual adjustment to his disability. Mention is made of guilt, shame, anxiety, depression, regression and denial as related to sudden and catastrophic illness. Agencies that can assist the patient and his family at home are also included.The proper care of the stroke patient must include the total person and should be based upon a thorough understanding of the psychological side of stroke.

No description available.

Subcortical hyperintensities (SH) are believed to be observable signs of cerebrovascular disease, indicating some form of subcortical vasculopathy. Also commonly referred to as leukoariosis, these hyperintense signals on proton density, T2-weighted and fluid attenuated inversion recovery magnetic resonance images, are commonly observed phenomena in Alzheimer’s disease patients and elderly persons. Several SH sub-types with differential brain-behavior associations have been proposed in the scientific literature: periventricular, deep white, cystic fluid filled lacunar-like infarcts and perivascular Virchow-Robin spaces. This study will present Lesion Explorer (LE): a comprehensive tri-feature MRI-based processing pipeline that effectively and reliably quantifies SH sub-types in the context of additional brain tissues volumetrics in a regionalized manner. The LE pipeline was validated using a scan-rescan procedure. Finally, the LE pipeline was applied in a cross-sectional study of Alzheimer’s disease patients and normal elderly controls. Brain-behavior relationships were demonstrated with regional SH volumes and executive functioning, speed of mental processing, and verbal memory.

The use of transcranial Doppler (TCD) ultrasound for the assessment of cerebral blood flow velocity (CBFV) provides an indication of cerebral blood flow assuming the diameter of the insonated vessel remains constant. Studies using TCD have traditionally described cerebrovascular hemodynamics with respect to CBFV and cerebrovascular resistance (CVRi); however, a more complete assessment of the cerebral circulation can be gleaned from the analysis of within beat characteristic of the TCD velocity waveform for the determination of cerebrovascular tone. Therefore, the general purpose of the presented studies was to assess CBFV responses and within beat characteristic for the description of cerebrovascular hemodynamics after long duration spaceflight, with sustained orthostasis, in response to changes in the partial pressure of end tidal carbon dioxide (PETCO2), and with NG stimulation. After long duration spaceflight, cerebrovascular autoregulation was found to be impaired along with a reduction in cerebrovascular CO2 reactivity (Study 1). Additionally, critical closing pressure (CrCP) was found to be increased suggesting potential remodelling of the cerebrovasculature contributing to an increase in cerebrovascular tone (Study 2). With sustained orthostasis, CBFV was found to progressively decrease and to be related to reductions in PETCO2 and increases in CrCP suggesting the contribution of changes in cerebrovascular tone leading to the development of syncope (Study 4). The CBFV reduction with the progression towards syncope was also associated with changes in waveform morphology such that the dicrotic notch point was less than the end diastolic value (Study 3). Mathematical modelling (RCKL) was used to further assess changes in cerebrovascular hemodynamics for physiological interpretation of changes in CBFV waveform morphology and found that the amplitude of the dicrotic notch and the calculation of the augmentation index were both significantly related to vascular compliance before and after stimulation with NG (Study 5). The use of quantitative assessments of common carotid artery (CCA) blood flow as an indicator of cerebral blood flow suggested the dilation of the middle cerebral artery (MCA) with NG (Study 5 and 6) and changes in MCA diameter with acute alterations in PETCO2 (Study 6). CCA and MCA velocity wave morphology were assessed showing that with changes in PETCO2, changes in CBFV velocity wave were not reflected in the CCA trace (Study 7). In addition, further assessment of the CBFV velocity trace and the calculation of CrCP and the augmentation index suggested that with changes in PETCO2 cerebrovascular compliance and cerebrovascular tension, both thought to be components of cerebrovascular tone, change independently (Study 7). Combined, the results of the presented studies suggest that changes in cerebrovascular hemodynamics can be determined from alterations in the CBFV velocity waveform morphology. However, further work is required to determine how these variations relate to specific components of cerebrovascular tone, including alterations in cerebrovascular compliance and vascular tension, and how these variables change with acute and chronic alterations in cerebrovascular hemodynamics.

Thesis (MAppSc in Physiotherapy) -- University of South Australia, 1994

Thesis (MAppSc in Physiotherapy) -- University of South Australia, 1994

Thesis (M. Sc.)--University of Canterbury, 2007. / Typescript (photocopy). Includes bibliographical references (leaves 74-77). Also available via the World Wide Web.

Thesis (M. P. H.)--University of Hong Kong, 2007.

Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.