DOI QR코드

DOI QR Code

A Case Report of Vascular Dementia Following Acute Cerebral Infarction and Subarachnoid Hemorrhage Improved by Comprehensive Korean Medicine

급성 대뇌경색증을 동반한 지주막하 출혈 이후 발생한 혈관성 치매 한의복합치료 1례

  • Ga-Hyun Lee (Department of Oriental Neuropsychiatry, Dong-Seo Korean Medical Center) ;
  • Seung-Woo Song (Department of Oriental Neuropsychiatry, Dong-Seo Korean Medical Center) ;
  • Se-Jin Park (Department of Oriental Neuropsychiatry, Dong-Seo Korean Medical Center)
  • 이가현 (동서한방병원 한방신경정신과) ;
  • 송승우 (동서한방병원 한방신경정신과) ;
  • 박세진 (동서한방병원 한방신경정신과)
  • Received : 2024.07.01
  • Accepted : 2024.09.08
  • Published : 2024.09.30

Abstract

Objectives: Vascular dementia (VaD) is a neurodegenerative disorder associated with cognitive impairment resulting from cerebrovascular pathology. This clinical case study aimed to evaluate the efficacy of Korean medicine treatment in treating VaD following an acute cerebral infarction and subarachnoid hemorrhage. Methods: The subject, a female in her 70s, reported cognitive impairment and right-sided hemiparesis following an acute cerebral infarction and subarachnoid hemorrhage. The patient received comprehensive treatment comprising herbal medicine, acupuncture, moxibustion, and cupping therapy for 108 days. We assessed improvements in cognitive impairment and neurological symptoms using the Korean version of the Mini-Mental Status Examination (MMSE-K), Global Deterioration Scale (GDS), and Korean version of Modified Barthel Index (K-MBI). Results: After treatment, both cognitive impairment and right-sided hemiparesis improved. Scores of MMSE-K, GDS, K-MBI, and MMT also increased. Conclusions: Korean medicine treatment could be considered for patients with vascular dementia following acute cerebral infarction and subarachnoid hemorrhage.

Keywords

Acknowledgement

This study was not supported by any affiliation.

References

  1. APA. Diagnostic and Statistical Manual of Mental Disorders: DSM. 5th. Seoul:Hakjisa. 2015:677-80.
  2. Seo EY. Vascular Dementia in Oriental Medicine. Dongeui University Institute of Oriental Medicine. 2003;7:83-88.
  3. Kim KW. A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea. National Institute of Dementia. 2017:7.
  4. Mijajlovic MD, Pavlovic A, Brainin M, Heiss WD, Quinn TJ, Ihle-Hansen HB. Post-stroke dementia-a comprehensive review. BMC Med. 2017;15:11. doi: 10.1186/s12916-017-0779-7
  5. Gillespie DC, Bowen A, Chung CS, Cockburn J, Knapp P, Pollock A. Rehabilitation for post-stroke cognitive impairment: an overview of recommendations arising from systematic reviews of current evidence. Clin Rehabil. 2015; 29:120-8. doi: 10.1177/0269215514538982
  6. O'Brien JT, Thomas A. Vascular dementia. Lancet. 2015; 386(10004):1698-706. https://doi.org/10.1016/S0140-6736(15)00463-8
  7. Jung MS, Kang HC, Lee SG. Clinical Report of One Patient with the Vascular dementia by Sesimtang mixed Gujuntag. Journal of oriental neuropsychiatry. 2007;18(2):163-171.
  8. Park K, Kim HJ, Son JY, Kwak MA, Kim SM, Kim DJ, et al. Case of Vascular Dementia Treated with Bojungikkitang-gamibang. Journal of physiology & pathology in Korean Medicine. 2008;22(4):943-947.
  9. Kim DJ, Park MY. Cases Report about Vascular Dementia Treated with Bojungikki-tang-gamibang. Journal of physiology & pathology in Korean Medicine. 2011;25(1):144- 148.
  10. Youn HS, Lee EC, Son JM, Kwon SW, Park CH, Kwon YJ, et al. A Case Report of a Patient with Vascular Dementia Caused by Intracerebral Hemorrhage Treated with Modified Guibi-tang. The journal of internal Korean medicine. 2023;44(5):1033-1040. https://doi.org/10.22246/jikm.2023.44.5.1033
  11. Hong SY, Kim TH, Han DN, Lim EC. Two Case Reports on Soeumin Woolgwang-incurable Disease with Vascular Dementia. Journal of Sasang Constitutional Medicine. 2007;19(2):213-222.
  12. Jang MH, Choi JS, Bae NY, Ahn TW. Three cases of Vascular Dementia Patients. Journal of Sasang Constitutional Medicine. 2011;23(3):402-411.
  13. Korean society of oriental neuropsychiatry. Korean Medicine Clinical Practice Guideline for Dementia. Seoul: Guideline center for Korean Medicine. 2021:13,28,135.
  14. Yim YK, Kim KS, Kim TH, Kim JP, Park HJ, Lee HS. Details of meridians & acupoints; a guide book for college students. Daejeon:Jongryeonamu Publishing Co. 2012: 244-5.
  15. Hwang DY. Bangyakhappyeon. Seoul:Yeongrim. 2010: 121-2.
  16. Lee DY, Kim JB, Ha DJ, Kwon CY. Classical,Non-Clinical, and Clinical Evidence of Yokukansan for Alleviating Aggression: Scoping Review. Journal of Oriental Neuropsychiatry. 2021;32(2):111-27. https://doi.org/10.7231/jon.2021.32.2.111
  17. Cho KH, Kim TH, Jin C, Lee JE, Kwon SW. The Literary Trends of Herbal Prescription Ukgan-San and Its Application in Modern Traditional Korean Medicine. Journal of Korean Medicine. 2018;39(3):17-27. https://doi.org/10.13048/jkm.18021
  18. Herbal Formula Science in Korean Medicine Textbook Compilation Committee. Herbal Formula Science in Korean Medicine. Seoul:Yeongnimsa. 2003:504-6.
  19. Li J, Mu Z, Xie J, Ma T, Zhang Y, Qi X, Teng J. Effectiveness and safety of Chinese herbal medicine Xiaoyao san for the treatment of insomnia: Protocol for a systematic review and meta-analysis. Medicine. 2019;98(29):1-4. https://doi.org/10.1097/MD.0000000000016481
  20. Kim WY. Jeon WK, Heo EJ, Park SY, Han CH. Literature Review and suggestions: dementia clinical studies in Korean Oriental Medicine. Korean Journal of Oriental Medicine. 2011;17(2):39-46.
  21. Lee SS. Review Study of Clinical Availability for Screening Test (MMSE, GDS, CDR). Hanyang Univercity Clinical Nurse Science. 2007;8:3-4, 35, 42.
  22. Young HY, Park BK, Shin HS, Kang YK, Pyun SB, Paik NJ, et al. Development of the Korean Version of Modified Barthen Index (K-MBI): Multi-center Study for Subjects. Annals of Rehabilitation Medicine. 2007;31(3):283-97.
  23. Han TR, Bang MS, Jung SK. Rehabilitation medicine. 6th. Paju:Gunja. 2019:13.
  24. Association of Korean Medicine College for Cardiology and Neurological Medicine. Cardiovascular and Neurological Medicine in Korean Medicine. Paju:Gunja. 2013: 472-6.
  25. Fergusen S, Macdonald RL. Predictors of cerebral infarction inpatients with aneurysmal subarachnoid hemorrhage. Neurosurgery. 2007;60(4):658-67. doi: 10.1227/01.NEU.0000255396.23280.31
  26. Oh SY, Choi KH, Ha SB. The Effect of Cognitive Deficit on Functional Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage. Journal of Korean Academy of Rehabilitation Medicine. 2001;25(4):543-550.
  27. Min SG, KIM CH. Modern Psychiatry. 6th. Seoul:Ilchokak. 2015: 224-251.
  28. Roman GC. Vascular dementia : distinguishing characteristics, treatment and prevention. Journal of the American Geriatrics Society. 2003;51(5):296-304. https://doi.org/10.1046/j.1532-5415.5155.x
  29. The Korean Dementia Association. Dementia: A Clinical approach. Seoul:Academya. 2006:413-425.
  30. Lyketsos CG, Lopez O, Jones B, Fitzpatrick AL, Breitner J, DeKosky S. Prevalence of Neuropsychiatric Symptoms in Dementia and Mild Cognitive Impairment: Results From the Cardiovascular Health Study. JAMA. 2002; 288(12):1475-1483. doi:10.1001/jama.288.12.1475
  31. Shin IS, Carter M, Masterman D, Fairbanks L, Cummings JL. Neuropsychiatric symptoms and quality of life in Alzheimer disease. Am J Geriatr Psychiatry. 2005;13(6): 469-74. doi: 10.1176/appi.ajgp.13.6.469
  32. Lee DW, Kim JB, Ha DJ, Kwon CY. Classical, Non-Clinical, and Clinical Evidence of Yokukansan for Alleviating Aggression: Scoping Review. Journal of Oriental Neuropsychiatry. 2021;32(2):111-127. https://doi.org/10.7231/JON.2021.32.2.111
  33. Galasko D, Klauber MR, Hofstetter CR, Salmon DP, Lasker B, Thal LJ. The Mini-Mental State Examination in the early diagnosis of Alzheimer's disease. Arch Neurol. 1990;47:49-52. https://doi.org/10.1001/archneur.1990.00530010061020
  34. Hodges JR, Salmon DP, Butters N. Differential impairment of semantic and episodic memory in Alzheimer's and Huntington's diseases: a controlled prospective study. Journal of Neurol Neurosurg Psychiatry. 1990;53: 1089-95. https://doi.org/10.1136/jnnp.53.12.1089
  35. Lee GE, Jeon WK, Heo EJ, Yang HD, Kang HW. The Study on the Korean Traditional Medical Treatment and System of Collaborative Practice Between Korean Traditional Medicine and Western Medicine for Dementia: Based on Analysis of Questionnaire Survey in Professional Group. Journal of Oriental Neuropsychiatry. 2012;23(4):49-68. https://doi.org/10.7231/JON.2012.23.4.049
  36. Kim BM, Jo HG, Kang HW, Choi SY, Song MY, Sul JU, Leem JT. Proposal of Evidence-based East-West Integrative Medicine Manual for Vascular Dementia. The Journal of Korean Medicine. 2019;40(1):46-62. https://doi.org/10.13048/jkm.19005