Prevalence and Recovery Duration of Pusher Syndrome in Stroke: A Cross-Sectional Study Including Posterior Cerebral Artery Involvement

Pusher syndrome, or contraversive pushing, is a common post-stroke condition, particularly in patients with right hemisphere lesions.It is characterized by an altered perception of verticality, leading patients to push toward their hemiplegic side, resulting in postural imbalance and increased fall risk.Unlike typical stroke patients who lean toward their weaker side, those with pusher syndrome actively push away from their non-paretic side, making rehabilitation more challenging.This study aimed to assess the prevalence of pusher syndrome in stroke patients, examine recovery duration, and evaluate its occurrence and rehabilitation outcomes in posterior cerebral artery (PCA) strokes.A 12-month cross-sectional observational study was conducted in a stroke rehabilitation facility using the Scale for Contraversive Pushing (SCP) and a questionnaire to assess pusher behavior in stroke survivors.PCA involvement was observed in 60% of participants, with pusher syndrome present in 36% of PCA cases.A significant association was found between PCA involvement and pusher syndrome (Chi-square = 23.70,P < 0.001), along with an impact on recovery duration (Chi-square = 37.0, P < 0.001).These findings emphasize PCA's role in pusher syndrome and its effect on rehabilitation.Pusher syndrome is more prevalent in PCA strokes, with moderate severity on the SCP scale.The results underscore the need for specialized rehabilitation strategies to manage pushing behavior in this stroke population.