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.
The author invented a method of evaluating disabled hands in activities of daily living or A D L by means of three cardinal functions, firstly, function of the hand or terminal effector, secondly, ability for the hand to reach and thirdly, ability to control trunk. The evaluated score by this method and the score in actual A D L test paralleled except in cases with mental disorders as in hemiplegia or with severe ataxia. This evaluating method will be valuable in wide applicability, simplicity and clinical guide for the disabled hands.
Cervical cord lesion is one of the most important problem in the field of rehabilitation. And the treatment of complete lesion has been systematized recently. But we have few chance to treat the complete lesion. We have to treat incomplete cases more frequently. However, we have not any systematic treatment procedure about such incomplete cases. So, we presented three cases of incomplete cervical cord lesion and explained the treatment procedure which we did.
It is our clinical experience that in a number of aphasics, a distinctive articulatory disorder is found in the absence of the observable paralysis or paresis of the speech musculature. The term “motor aphasia” or “Broca's aphasia” has generally been applied to designate this type of disorder. The studies in recent years, however, have disclosed that this kind of disorder, a disorder of programming and executing articulatory movements (verbal apraxia or apraxia of speech), can be distinguished from the disorder of symbolic processes, i. e. aphasia. In this paper, the characteristics of verbal apraxia were described as well as the methods of testing oral and verbal apraxias. The therapy methods of verbal apraxia were reviewed with a special emphasis on the works done by Luria, et al.. It was suggested that verbal apraxia, though a clearly definable clinical entity, might not be a homogeneous disorder. More comprehensive investigation of the nature of this disorder will be necessary before we can set up more systematic therapeutic procedures.