• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.763-775
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• 2021

Objective : Hemorrhagic transformation (HT) can be occurred after acute cerebral infarction. HT can worse symptoms in severe cases and adversely affect long-term prognosis. As bone and vascular smooth muscle are composed of type 1 collagen, we aimed to identify a potential relationship between bone mineral density (BMD) and HT after acute cardioembolic stroke. Methods : As an indicator of BMD, we used mean frontal skull Hounsfield unit (HU) values on brain computed tomography (CT). Multivariative hazard ratios were calculated using Cox regression analysis to identify whether the osteoporotic condition was an independent predictor of HT after acute cardioembolic stroke. Results : This 11-year analysis enrolled 506 patients who diagnosed as acute cardioembolic infarction. The first tertile of skull HU value was an independent predictor of HT development compared to the third tertile (hazard ratio, 2.12; 95% confidence interval, 1.13-3.98; p=0.020). We observed no interactions between age and skull HU with respect to HT statistically. Conclusion : The results of this study revealed an association between osteoporotic conditions and HT development after acute cardioembolic stroke. A convenient method to measure the cancellous bone HU value of the frontal skull using brain CT images may be useful for predicting HT in patients with acute cerebral infarction.

• Korean Journal of Radiology
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• 제21권1호
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• pp.101-107
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• 2020

Objective: Avoiding a catastrophic outcome may be a more realistic goal than achieving functional independence in the treatment of acute stroke in octogenarians. This study aimed to investigate predictors of catastrophic outcome in elderly patients after an endovascular thrombectomy with an acute anterior circulation large vessel occlusion (LVO). Materials and Methods: Data from 82 patients aged ≥ 80 years, who were treated with thrombectomy for acute anterior circulation LVO, were analyzed. The association between clinical/imaging variables and catastrophic outcomes was assessed. A catastrophic outcome was defined as a modified Rankin Scale score of 4-6 at 90 days. Results: Successful reperfusion was achieved in 61 patients (74.4%), while 47 patients (57.3%) had a catastrophic outcome. The 90-day mortality rate of the treated patients was 15.9% (13/82). The catastrophic outcome group had a significantly lower baseline diffusion-weighted imaging-Alberta stroke program early CT score (DWI-ASPECTS) (7 vs. 8, p = 0.014) and a longer procedure time (42 minutes vs. 29 minutes, p = 0.031) compared to the non-catastrophic outcome group. Successful reperfusion was significantly less frequent in the catastrophic outcome group (63.8% vs. 88.6%, p = 0.011) compared to the non-catastrophic outcome group. In a binary logistic regression analysis, DWI-ASPECTS (odds ratio [OR], 0.709; 95% confidence interval [CI], 0.524-0.960; p = 0.026) and successful reperfusion (OR, 0.242; 95% CI, 0.071-0.822; p = 0.023) were independent predictors of a catastrophic outcome. Conclusion: Baseline infarct size and reperfusion status were independently associated with a catastrophic outcome after endovascular thrombectomy in elderly patients aged ≥ 80 years with acute anterior circulation LVO.

• 대한한방내과학회지
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• 제21권2호
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• pp.203-212
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• 2000

Objective : We studied only patients at the acute stage but existing studies on stroke didn't almost classify the stage. We examined 243 patients admitted to the Woo Suk university oriental medical hospital from January 1998 to December 1999 for 2 years. Methods : We analyzed patients into sex, Sasang constitution, the incidence and lesion according to the stroke types, post and family history, onset time, period to admission and physical treatment from onset, and symptom, blood pressure, cholesterol level and herb medicine at entry. Results : Our study was similar to existing studies in the distribution of sex, age and the lesion of stroke, post and family history, and symptoms at entry. But it differed in the constitution, incidence of cerebral infarction and intracranial hemorrhage, attack time, period to admission and physical treatment from onset day, and the symptoms, blood pressure, cholesterol level and herb medication. In comparison between infarction and hemorrhage patients, there was some difference in the distribution of onset time, but wasn't in the cholesterol level. Conclusions : Our study on the acute stage of stroke was similar to existing studies in the general characteristics. But it showed some differences in the herb medicine at entry. In particular, there were much differences in the blood pressure at entry and the incidence of infarction and hemorrhage. We hoped that stroke patients would be synthetically studied in western and oriental medicine.

• 대한한의학회지
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• 제25권1호
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• pp.111-116
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• 2004

Objective : To assess the clinical efficacy of Yangkyuksanwha-tang on acute stroke Methods : We prescribed Yangkyuksanwha-tang to 83 acute stroke patients without thrombolytic treatment. Results : The rate of progressive stroke type was 1.2%, it was remarkably lower than previous reports. 3.6% felt an itching sensation, 3.6% complained headache, dizziness and powerless, 2.4% complained indigestion and diarrhea, 1.2% appeared hematuria and G-I bleeding. Yangkyuksanwha-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale(NIHSS), and increased Modified Barthel Index(MBI). So we could suggest that this medicine have desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, all results were within the normal value, which showed no hepatic or renal toxicity. Conclusion : We could suggest that Yangkyuksanwha-tang is a useful medicine which has clinical efficacy for acute stroke, but further investigation for an administration of more than 2 weeks is necessary.

• Journal of Korean Neurosurgical Society
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• 제67권2호
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• pp.186-193
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• 2024

Objective : The treatment paradigm for acute ischemic stroke has undergone several major changes in the past decade, contributing to improved patient prognosis in clinical practice. However, the extent to which these changes have affected patient prognosis in the real-world is yet to be clarified. This study aimed to evaluate the real-world impact of modern reperfusion therapy for acute ischemic stroke using data from the National Health Insurance Service in Korea. Methods : This study included patients aged 18-80 years who were admitted via the emergency room with an I63 code between 2011 and 2020. The rates of intravenous thrombolysis use and endovascular treatment according to the year of admission were investigated. Furthermore, the rates of decompressive craniectomy and 3-month mortality were also analyzed. The 10-year observational period was divided into three periods based on the 2015 guideline change as follows : prior, 2011-2014; transitional, 2015-2016; and modern, 2017-2020. Results : A total of 307117 patients (mean age, 65.7±10.9 years) were included, and most patients were male (59.7%). The rate of endovascular treatment gradually increased during the study period from 0.71% in the prior period to 1.32% in the transitional period and finally to 1.85% in the modern period. Meanwhile, the 3-month mortality rate gradually decreased from 4.78% in the prior period to 4.03% in the transitional period and to 3.71% in the modern period. Conclusion : In Korea, the mortality rate decreased as the rate of modern reperfusion therapy increased in patients with acute ischemic stroke. Overall, technical and scientific advances in reperfusion therapy have improved the outcome of patients with acute ischemic stroke in Korea.

• 대한중풍순환신경학회지
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• 제7권1호
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• pp.54-58
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• 2006

Objectives : This study was aimed to investigated the relationship between warning signs and stroke subtype in acute stroke patients. Methods : From Oct. in 2005 to Oct. in 2006, 409 acute stroke patients were included. Patients were hospitalized within 14 days after the onset of stroke in DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital, Department Cardiovascular and Neurologic Diseases(Stroke center) Kyung Hee University Oriental hospital. We investigated general characteristics, stroke subtype, and warning signs(facial spasm, neck stiffness). Results : Hemorrhagic stroke had more facial spasm than ischemic stroke. (odds ratio 3.60) Small vessel occlusion had more neck stiffness than others. (odds ratio 2.03) Conclusion : To acquire more concrete conclusions on warning signs, we need further and large scale of prospective researches.

• 대한중풍순환신경학회지
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• 제11권1호
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• pp.70-75
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• 2010

Objective : This study is aimed to investigate the present status in acute stroke patients in Koran medicine hospital. Method : We used the Korean medicine stroke database. We collected data from 4 Korean medicine hospital from Feb. 2010 to Aug. 2010. We surveyed past history, motive, diseases, diagnostic machines, the day from onset to admission in acute stroke patients. Results : 1. In Korean medicine hospital, it has been grown up the portion of cerebral infarction and age. 2. In Korean medicine hospital, the patients within 1 day from onset to admission were 63case(34.60%) 3. In Korean medicine hospital, the diagnotic machine has been well used, but MRA utilzation was low. 4. Acute stroke patients were not well known the risk factor, and the patients cerebral infarction didn't know that they had hyperlipidemia. Conclusions : In this study, we know the present status in acute stroke patients. It seems necessary to investigate more further study.

• 대한한의학방제학회지
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• 제15권2호
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• pp.171-178
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• 2007

This study is clinical report for a acute stroke patient who was improved by treatment of a herbal medication. Stroke patients often shows spirit disorder in early stage. However, the cases which applied Onbyung theory are rare. This paper aims to show that Onbyung theory can be effective to acute stroke. We diagnosed the patient as invasion of the yong system by heat(熱入營分), which showed confusion, insomnia, delirium, anxiety, reddened tongue and dry mouth with cracked lip. After administration of Chungyung-tang(淸營湯) in Wen bing Tiao (溫病條辨), the patient showed those symptoms were highly improved. Thus, we concluded that Onbyung Theory can the patient be adapted to improve the symptom of acute stroke.

• Journal of Korean Neurosurgical Society
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• 제55권6호
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• pp.313-320
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• 2014

Objective : The purpose of this study is to demonstrate the technical feasibility and clinical efficacy of emergent carotid angioplasty and stenting (CAS) for acute stroke due to athero-thrombotic occlusion of the cervical internal carotid artery (ICA). Methods : Review of medical records identified 17 patients who underwent emergent CAS for treatment of athero-thrombotic occlusion of the cervical ICA with acute stroke between 2009 and 2013. Eleven patients (64.7%) presented with concomitant intracranial artery occlusion, which was treated primarily by mechanical thrombectomy after CAS. Results : Successful revascularization of the cervical ICA with emergent CAS was achieved in all patients. After CAS, intracranial recanalization with Thrombolysis in Cerebral Infarction ${\geq}2b$ flow was achieved in four of the 11 patients (36.4%). The overall recanalization rate (cervical ICA and intracranial artery) was 10 of 17 patients (58.8%). Symptomatic intracranial hemorrhage occurred in two patients (11.8%), resulting in death. Ten patients (58.8%) showed improvement (decrease in NIHSS score of ${\geq}4$ points) at seven days after recanalization. Nine patients (52.9%) showed a favorable outcome ($mRS{\leq}2$) at the last follow-up. A favorable outcome ($mRS{\leq}2$) was obtained in four of the six patients with isolated cervical ICA occlusion (4/6, 66.7%) and five of 11 patients with intracranial tandem occlusion (5/11, 45.5%). Conclusion : Emergent CAS for acute stroke due to athero-thrombotic occusion of the cervical ICA showed a good technical feasibility and favorable clinical outcome.

• The Journal of Korean Physical Therapy
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• 제30권4호
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• pp.112-116
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• 2018

Purpose: This study aimed to identify the effects of a task-oriented exercise program on balance in patients with acute stroke. Methods: Twenty participants with hemiparesis resulting from acute stroke volunteered to participate in this study. They were randomly assigned to either the experimental or control group, with 10 patients per group. Both groups underwent a task-oriented exercise program averaging 30 minutes daily for 4 weeks. Balance was assessed before and after the 4-week training period. Before and after the intervention, we conducted a paired t-test to compare the within-group changes and an independent t-test to compare the between-group differences. The statistical significance level was set at p=0.05 for all the variables. Results: Both groups showed significant within-group and between-group changes in balance (p<0.05) after the intervention. Conclusion: This study provides valuable information for future studies in this field. Further research using a larger sample and longer experiment spans can corroborate the results of our study.