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regular, or intermittent respiration; dilated, xed pupils, rst on the side of the clot; and occasionally by decerebrate rigidity The widespread use of CT scanning has disclosed the frequent occurrence of smaller putaminal hemorrhages, which in former times would have been misdiagnosed as embolic or thrombotic ischemic strokes (especially if the CSF was clear) With hemorrhages con ned to the anterior segment of the putamen, the hemiplegia and hyperre exia tend to be less severe and to clear more rapidly (Caplan) There is also prominent abulia, motor impersistence, temporary unilateral neglect, and with left-sided lesions non uent aphasia and dysgraphia With posterior lesions, weakness is also less and is attended by sensory loss, hemianopia, impaired visual pursuit to the opposite side, Wernicke-type aphasia (leftsided lesions), and anosognosia (right-sided) Caplan has also analyzed the effects of relatively pure caudate hematoma Those extending laterally and posteriorly into the internal capsule behave much like large putaminal hemorrhages Those extending medially into the lateral ventricle give rise to drowsiness, stupor, and either confusion and underactivity or restlessness and agitation Thalamic Hemorrhage The central feature here is severe sensory loss on the entire contralateral body If large or moderate in size, thalamic hemorrhage also produces a hemiplegia or hemiparesis by compression or destruction of the adjacent internal capsule (Fig 34-21) The sensory de cit is usually severe and involves all of the opposite side, including the trunk, and may exceed the motor weakness A uent aphasia may be present with lesions of the dominant side, and amorphosynthesis and contralateral neglect with lesions of the nondominant side A homonymous eld defect, if present, usually clears in a few days Thalamic hemorrhage, by virtue of its extension into the sub-

Higher-OrderCorrections ProblemStotement In Example181, usedRichardson we extrapolation compute to two integralestimates Othl) Utilize Eq (186)to combinetheseestimates computean of to w integral ithOtlr6t Solution The two integralestimates O(h1) obtained Examplel8l were 1361461 in of into Eq ( I 86) to yield and 1623461Thesevaluescan be substituted

N/A (x,y)

Figure 34-21 CT scan of a left thalamic hemorrhage that caused hemiplegia and hemisensory loss in a hypertensive patient A small amount of blood is seen in the adjacent posterior third ventricle

in Notice that the coefficients eachof the extrapolation equations [Eqs(185),(186),and (187)l add up to l Thus thev reoresent weichtinefactorsthat as accuracv increases

Table 13-10

.

For example, here's how to create a table that will hold the time information for a task:

placerelatively greaterweight on the superiorintegralestimate Theseformulations be can in expressed a generalfbrm that is well suitedfor computerimplementation: