Motor recovery beginning 23 years after ischemic stroke

Peter Sörös, Robert Teasell, Daniel F Hanley, J. David Spence

Research output: Contribution to journalArticle

Abstract

It is widely believed that most stroke recovery occurs within 6 mo, with little benefit of physiotherapy or other modalities beyond 1 yr. We report a remarkable case of stroke recovery beginning 23 yr after a severe stroke due to embolization from the innominate artery and subclavian artery, resulting from compression of the right subclavian artery by a cervical rib. The patient had a large right frontoparietal infarction with severe left hemiparesis and a totally nonfunctional spastic left hand. He experienced some recovery of hand function that began 23 yr after the stroke, 1 yr after he took up regular swimming. As a result, intensive physiotherapy was initiated, with repetitive large muscle movement and a spring-loaded mechanical orthosis that provides resistance to finger flexors and supports finger extensors. Within 2 yr, he could pick up coins with the previously useless left hand. Functional MRI studies document widespread distribution of the recovery in both hemispheres. This case provides impetus not only to more intensive and prolonged physiotherapy, but also to treatment with emerging modalities such as stem cell therapy and exosome and microRNA therapies. NEW & NOTEWORTHY Widespread bilateral activation of both sides of the cerebrum and cerebellum are demonstrated on functional MRI after motor recovery of a completely nonfunctional left hand that began 23 yr after a severe stroke. This suggests that the generally accepted window of recovery beyond which further therapy is not indicated should be entirely reconsidered. Physiotherapy and new modalities in development might be indicated long after a stroke.

Original languageEnglish (US)
Pages (from-to)778-781
Number of pages4
JournalJournal of Neurophysiology
Volume118
Issue number2
DOIs
StatePublished - Aug 1 2017

Fingerprint

Stroke
Hand
Subclavian Artery
Fingers
Cervical Rib
Magnetic Resonance Imaging
Brachiocephalic Trunk
Exosomes
Orthotic Devices
Numismatics
Muscle Spasticity
Recovery of Function
Cerebrum
Paresis
Cell- and Tissue-Based Therapy
MicroRNAs
Cerebellum
Infarction
Stem Cells
Therapeutics

Keywords

  • Delayed
  • Functional MRI
  • Motor
  • Recovery
  • Stroke

ASJC Scopus subject areas

  • Neuroscience(all)
  • Physiology

Cite this

Motor recovery beginning 23 years after ischemic stroke. / Sörös, Peter; Teasell, Robert; Hanley, Daniel F; Spence, J. David.

In: Journal of Neurophysiology, Vol. 118, No. 2, 01.08.2017, p. 778-781.

Research output: Contribution to journalArticle

Sörös, Peter ; Teasell, Robert ; Hanley, Daniel F ; Spence, J. David. / Motor recovery beginning 23 years after ischemic stroke. In: Journal of Neurophysiology. 2017 ; Vol. 118, No. 2. pp. 778-781.
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