Pushers syndrome

[Previous Participant]

Hello all,

I wanted to confirm pushers syndrome is also known as contraversive pushing correct?

Also, I saw on the NCS advantage handouts that pushers syndrome is ” Typically associated with posterolateral thalamus strokes”. However, on Shepard Book it states that it is “typically associated with posterior inferior cerebellar artery or lesion to the lateral medulla”. It also mentions pushing ipsilateral to lesion vs. pushing contralateral to the lesion. I think I am just getting it confused with the wording.

Can someone please break it down for me to better understand and not get words mixed up on the day of the exam.

Thank you.

[Chrissy Durrough Lugge]

Hi Pamela,

Pushers syndrome is also known as contraversive pushing. Affected individuals will push contralateral to their brain lesion (and toward their affected limbs)- they will use their unaffected limbs to push toward their affected limbs. So, if someone has a left-sided stroke with right hemiparesis, they will use their left limbs to push toward their right side.

Most sources I am seeing generally cite the posterolateral thalamus as the culprit in pushers syndrome.
– https://www.neurology.org/doi/full/10.1212/01.WNL.0000154527.72841.4A
– https://pmc.ncbi.nlm.nih.gov/articles/PMC3226615/

There is some association with lateral medullary syndrome (posterior inferior cerebellar artery) and pushing.
– https://www.tandfonline.com/doi/full/10.1080/10749357.2021.1886640

Another one of those messy ones where knowing the general presentation will go a long way.

Chrissy

[Previous Participant]

Thank you Chrissy!:)

[Author]

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