언제나 희망은 있다. 포기하지 말고 고객들의 회복을 도와 주어야 한다.

It is widely believed that most stroke recovery occurs within 6 mo, with little benefit of physiotherapy or other modalities beyond 1 yr.  We report a remarkable case of stroke recovery beginning 23 yr after a severe stroke due to embolization from the innominate artery and subclavian artery, resulting from compression of the right sub-clavian artery by a cervical rib. The patient had a large right fronto-parietal infarction with severe left hemiparesis and a totally nonfunctional spastic left hand. He experienced some recovery of hand function that began 23 yr after the stroke, 1 yr after he took up regular swimming. As a result, intensive physiotherapy was initiated, with repetitive large muscle movement and a spring-loaded mechanical orthosis that provides resistance to finger flexors and supports finger extensors. Within 2 yr, he could pick up coins with the previously useless left hand. Functional MRI studies document widespread distribution of the recovery in both hemispheres. This case provides impetus not only to more intensive and prolonged physiotherapy, but also to treatment with emerging modalities such as stem cell therapy and exosome and microRNA therapies.