The diseases that most frequently cause hemiparesis are on a vascular and traumatic basis.
The most frequent lesions to vascular genesis are the cerebral hypoaffluxury lesions, the so-called ischemic stroke, and the haemorrhagic lesions (breakage of artero-venous malformation, hypertension lesion) the so-called haemorrhagic stroke.
Injury on the basis of traumatic injuries, traffic accidents mainly, cause either a direct cranial or secondary injury to the onset of haematoma.
Traumatic damage sometimes involves the entire hemisphere, creating deformities in the four limbs, a picture sadly known with the term spastic tetraparesis. The spastic patient is a patient who sees his autonomy and functionality lost due to the difficulty of performing normal daily occupations and the considerable difficulty in walking, one understands what serious psychological drama the hemiparous event constitutes.
The medical practice consists in most cases of the simple management of medical therapy and for the lucky ones of motor re-education, which often aims only to avoid the worsening of deformities.
This is why the need arises to face in a multidisciplinary way the patient with these serious deformities through the collaboration of physiatry, physiotherapist and neurortopedico.
But what is the role of surgery in these patients? The hemiplegic patient is a still functionally valid patient, a patient suffering from limb deformities but with muscle groups still active even if atypically.
The role of surgery is therefore to correct spastic deformities by correcting the activity of 21 spastic muscles.