Letter by santos-pontelli et Al regarding article, "prevalence and length of recovery of pusher syndrome based on cerebral hemispheric lesion side in patients with acute stroke".

BACKGROUND AND PURPOSE The aim of this study was to determine if side of cerebral hemisphere lesion affects the prevalence and time course of pushing behavior (PB) after stroke. METHODS A total of 1660 patients with acute stroke were investigated. PB was assessed using the standardized Scale for Contraversive Pushing. Risk ratios were used to evaluate the differences in the prevalence of PB between right cerebral hemisphere-damaged (RCD) and left cerebral hemisphere-damaged (LCD) patients. The differences in the time course among 35 (27 RCD and 8 LCD) patients were evaluated by analyzing Scale for Contraversive Pushing scores with the Kaplan-Meier method using a log-rank test. RESULTS PB was observed in 156 (9.4%) patients. The prevalence of PB was significantly higher in RCD (97 of 556 [17.4%]) than in LCD (57 of 599 [9.5%]) patients; risk ratio was 1.83 (95% CI, 1.35-2.49). The log-rank test indicated that RCD patients exhibited a significantly slower recovery than LCD patients (P=0.027). CONCLUSIONS The number of RCD patients who exhibited PB was higher than that of LCD patients. The duration of recovery from PB was longer in RCD patients than in LCD patients.