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nearly complete within a week In cases of severe de cit, there may be no signi cant recovery; after months of assiduous efforts at rehabilitation, the patient may remain bereft of speech and understanding, with the upper extremity still useless and the lower extremity serving only as an uncertain prop during attempts to walk Between these two extremes there is every gradation of recovery In general, and not surprisingly, the longer the delay in onset of recovery, the poorer the prognosis Measurement of central motor conduction by magnetic stimulation has been predictive of recovery and survival but is not widely used for clinical work If clinical recovery does not begin in 1 or 2 weeks, the outlook is gloomy for both motor and language functions Constructional apraxia, uninhibited anger (with left and rarely with right temporal lesions), nonsensical logorrhea and placidity, unawareness of the paralysis and neglect (with nondominant parietal lesions), and confusion and delirium (with nondominant temporal lesions) all tend to diminish and may disappear within a few weeks A hemianopia that has not cleared in a few weeks will usually be permanent, although reading and color discrimination may continue to improve In lateral medullary infarction, dif culty in swallowing may be protracted, lasting 4 to 8 weeks or longer; yet relatively normal function is nally restored in nearly every instance Aphasia, dysarthria, cerebellar ataxia, and walking may improve for a year or longer, but for all practical purposes it may be said that whatever motor and language de cits remain after 5 to 6 months will be permanent Characteristically, the paralyzed muscles are accid in the rst days or weeks following a stroke; the tendon re exes are usually unchanged but may be slightly increased or decreased Gradually spasticity develops, and the tendon re exes become brisker The arm tends to assume a exed adducted posture and the leg an extended one Function is rarely if ever restored after the slow evolution of spasticity (however, the use of botulinum toxin may help considerably in relieving the spasticity) Conversely, the early de-.

Note here the inclusion of two null arguments after the DSN under most DBDs, this is the user name and password required to connect to the database The object will be undefined if an error occurs

Figure 34-18 Massive ischemic infarct of left cerebral hemisphere mainly in the distribution of the superior division of the middle cerebral artery CT scans taken 24 h (left) and 72 h (right) following the onset of neurologic symptoms The second scan demonstrates marked swelling of the infarcted tissue and displacement of central structures

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When using the Win32::ODBC module, the process is slightly more complex You can use the same basic method import the module and then create a new object using a specific DSN:

.

Use Win32::ODBC; $database = new Win32::ODBC("DSN" [, CONNECT_OPTION, ]);

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