We retrospectively studied the medical records of 26 patients with cardioembolic stroke who were consecutively transferred from acute phase hospitals (APH) to our hospital, as to whether their anticoagulant therapy was within the range of recommendations set by the Japanese Guidelines for the Management of Stroke 2004 (Guidelines). Seventeen of the transferred patients had their international normalized ratio (INR) result shown in the medical record, 10 of these transferred patients had their INR dictated as within target. The INRs at the day of transfer were 1.1-3.2, average 2.0±0.6. Fifteen of the patients had an INR within the Guideline's range of recommendation. Three patients experienced an INR>4.0 during their stay in our hospital and this was probably due to the additive bucolome and low frequency of INR examination. At the time of discharge, the INR of 8 patients still did not reach the Guideline's range of recommendation. Because the date of transfer from an APH to a rehabilitation hospital for patients with stroke is getting shorter than ever, it is possible that patients are now being admitted to the rehabilitation hospital before their anticoagulant therapy has stabilized. It is suggested that doctors in both APHs and rehabilitation hospitals should share information about each patient's anticoagulant therapy and follow the Guidelines.

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In the rehabilitation of traumatic brain injury, emotional disorders such as a quick temper, depression and irritability are a critical problem, as well as cognitive dysfunctions such as impairment of attention and memory. In addition, it is rare that they are completely isolated and cognitive dysfunction and emotional disorders tend to have an influence on each other. In other words, the stress caused by cognitive dysfunction induces an aggressive emotional disturbance, and unrest of mood accelerates cognitive dysfunctions such as memory and judgment. Therefore, it is important to consider their emotional states when we start rehabilitation for patients with traumatic brain injury. We had a valuable experience in early rehabilitation of two patients with traumatic brain injury. We had very good results by thinking about the emotional disorder first, and thereafter training for the cognitive dysfunction. Case 1, a young male, was a computer programmer. After suffering a traumatic brain injury, he could not think logically and he had many emotional problems with his mother. Case 2 was a middle-aged housewife. She became depressive and negative towards rehabilitation, because of her memory problems post traumatic brain injury. We administered a rehabilitation regime which attached great importance to treating the emotional disorders affecting these two patients. As a result, in the early phase, we were able to make progress in cognitive rehabilitation as well as improving their emotional problems by our intervention, and they overcame their cognitive dysfunctions and resumed their normal daily lives in a month.

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[in Japanese]

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Present and Future of Rehabilitation for Coordination Disorder…Tomiyoshi CHIDA 745

Pathophysiology of Coordination Disorder…Shozo TOBIMATSU, Takayuki TANIWAKI 750

Diagnosis and Therapy of Coordination Disorder…Takenori UOZUMI, Akira TAMAGAWA 758

Evaluation of Coordination Disorder in Rehabilitation Medicine…Yoshihisa MASAKADO 762

Therapeutic Approach of Coordination Disorder in Rehabilitation Medicine…Katsunori IKOMA 766

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[in Japanese]

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