• 대한한방내과학회지
• /
• 제43권2호
• /
• pp.175-183
• /
• 2022

Objective: The aim of this study is to report the improvement of a basal ganglia infarction patient with left hemiplegia and gait disturbance after treatment with Korean medicine. Methods: The patient was treated using acupuncture, moxibustion, and herbal medicine. To evaluate the effect on clinical symptoms, a manual muscle test, the Modified Functional Ambulation Classification, and the Korean version of the Modified Barthel Index were used. Results: After 118 days of treatment, scores for all three scales improved. Conclusion: Treatment with Korean medicine appears to be effective for improving the clinical symptoms of basal ganglia infarction with hemiplegia and gait disturbance, but further research is needed to verify this.

• 대한한의학회지
• /
• 제37권3호
• /
• pp.131-138
• /
• 2016

Objectives: Chorea Hyperglycemia Basal Ganglia Syndrome(C-H-BG) is a syndrome with chorea-ballismus induced by hyperglycemia. This case study reports the clinical effect of Korean medicine treatment on C-H-BG. Methods: A 73-year-old male patient with left side chorea-ballismus visited Daejeon Korean Medicine Hospital. He had no diabetes mellitus(DM) history but the laboratory test result suggested nonketotic DM. We diagnosed him as C-H-BG and treated with herbal medicine, acupuncture and hyperglycemic medication. To evaluate chorea-ballismus, we checked Abnormal Involuntary Movement Scale(AIMS) score everyday. Results: After 14 days of treatment, the chorea-ballismus improved and AIMS score decreased from 38 to 4. Gait disturbance caused by the symptom disappeared. Conclusions: We suggest that Korean medicine treatment can improve the symptom of C-G-BG.

• Journal of Korean Neurosurgical Society
• /
• 제54권2호
• /
• pp.125-127
• /
• 2013

Here, we report a rare case of an anaplastic astrocytoma masquerading as a hypertensive basal ganglia hemorrhage. A 69-year-old woman who had been under medical management for hypertension during the past 3 years suddenly developed right hemiparesis with dysarthria. Brain computed tomography (CT) scans with contrast and CT angiograms revealed an intracerebral hemorrhage (ICH) in the left basal ganglia, without an underlying lesion. She was treated conservatively, but underwent a ventriculoperitoneal shunt operation 3 months after the initial attack due to deteriorated mental status and chronic hydrocephalus. Three months later, her mental status deteriorated further. Magnetic resonance imaging (MRI) with gadolinium demonstrated an irregular enhanced mass in which the previous hemorrhage occurred. The final histological diagnosis which made by stereotactic biopsy was an anaplastic astrocytoma. In the present case, the diagnosis of a high grade glioma was delayed due to tumor bleeding mimicking hypertensive ICH. Thus, a careful review of neuroradiological images including MRI with a suspicion of tumor bleeding is needed even in the patients with past medical history of hypertension.

• 대한유전성대사질환학회지
• /
• 제14권2호
• /
• pp.163-167
• /
• 2014

DiGeorge syndrome is a disorder caused by microdeletion in chromosome 22q11.2 with various abnormalities including cardiac anomaly, facial dysmorphism, thymic and parathyroid hypoplasia, cleft palate and immune dysfunction. The frequency of hypocalcemia caused by hypoparathyroidism is known to be approximately 60% of DiGeorge syndrome. It is known that the disorder mostly occurs in the neonatal period and the symptoms are improved afterwards. Herein we report a case of DiGeorge syndrome only accompanied by hypocalcemia caused by hypoparathyroidism without other abnormalities. She was first diagnosed only at the age of 22 with basal ganglia calcification that had been discovered in brain CT (Computed tomography).

• Journal of Genetic Medicine
• /
• 제21권1호
• /
• pp.36-40
• /
• 2024

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episode (MELAS) syndrome is a maternally inherited mitochondrial disorder that usually affects the cerebral cortex and prevents high-energy demands from being met. Herein, we present the case of a male patient who rapidly developed multiple seizures, headaches, and altered mentality accompanied by severe metabolic acidosis and lactic acidosis. Initially, a brain imaging study confirmed stroke-like lesions (SLLs) only in the cerebellum. During follow-up, newly developed SLLs with lactic acidosis were observed in the basal ganglia (BG), cerebellum, and occipital lobe. The m.3243A>G variant had been found in the patient and MELAS was diagnosed, despite the BG and cerebellum being atypical locations for SLLs in MELAS. Since most cases of m.3243A>G variant MELAS show SLLs in the cerebral cortex, this case is unusual considering the location of the lesion. We emphasize that in the case of lactic acidosis accompanied by neurological symptoms, such as seizures, as in this case, MELAS should be included in the differential diagnosis, even if SLLs are observed in areas other than the cerebral cortex.

• 한국산업보건학회지
• /
• 제20권1호
• /
• pp.29-40
• /
• 2010

This study was aimed at investigating the gene expression profile in basal ganglia of cadmium exposed rat based on cDNA array analysis. For cDNA array analysis, adult Sprague-Dawley male rats (350 ${\pm}$ 25 g) were intraperitoneally injected with 2.0 mg/kg body weight/day of CdCl2 (0.3 ml) for 5 days. For doserelated gene expression analysis rats were intraperitoneally injected with 0.0, 0.1, 0.3, 1.0 mg/kg body weight/day of CdCl$_2$ for 5 days. Control rats were injected with equal volume of saline. Cadmium concentration of brain was analyzed by atomic absorption spectrophotometer. For cDNA array, RNA samples were extracted from basal ganglia and reverse-transcribed in the presence of [${\alpha}$32P]-dATP. Membrane sets of the Atlas Rat 1.2 array II and Toxicology array 1.2 (Clontech, Palo Alto, CA) were hybridized with cDNA probe sets. RT-PCR was employed to validate the relative gene expression patterns obtained from the cDNA array. Northern blot hybridization methods were employed to assess the dose-related gene expression. Among the 2352 cDNAs, 671 genes were detected in both array sets and 63 genes of 38 classes showed significant (more than two fold) changes in expression. Thirty five of these genes were up-regulated and twenty eight were down-regulated in the cadmium exposed group. According to the dose-related gene expression analysis, heat shock 27 kDa protein (HSP27), neurodegeneration-associated protein 1 (Neurodap 1) genes were significantly up-regulated and melatonin receptor 1a (Mel1a), Kinesin family member 3C (KIF3C), novel kinesinrelated protein (KIF1D) genes were significantly downregulated even in the low-dose of cadmium exposed group (0.1 mg/kg body weight/day). Conclusions Sixty three genes detected in this study can give some more useful informations about the cadmium-induced neurotoxicity in the basal ganglia. As well as, HSP27, Neurodap1, Mel1a, KIF3C and KIF1D genes may be useful for the study of the cadmium-induced neurotoxicity because these genes showed dramatic changes of mRNA levels in response to the low dose of cadmium exposure.

• 생물정신의학
• /
• 제8권2호
• /
• pp.271-275
• /
• 2001

60세 남자 환자로 좌측 정중 전두엽과 양측 기저절 경색 후 발생한 과잉성욕 증상과 강박 증상을 주소로 내원하였다. 환자는 뇌졸중 후에 발생한 운동 기능 장애는 시간이 경과하면서 호전되어 발병 1개월 이내에 거의 정상화된 반면 과잉성욕 증상과 강박 증상은 호전되지 않았다. 환자에게 과잉성욕 증상과 강박 증상을 목표로 fluvoxamine과 perphenazine을 처방하였으며 치료 시작 후 2개월이 경과하면서 환자의 과잉성욕 증상과 강박 증상은 서서히 사라졌다. 이 증례는 기저절-시상전두엽 회로가 성적 행동과 강박 증상의 조절에 있어 중요한 역할을 하고 있음을 시사한다고 할 수 있다. 과잉성욕 증상은 임상에서 간과하기 쉽고 또한 일반적으로 성적 활동에 대한 변화는 환자들 스스로 보고하지 않는 경향이 많다. 따라서 뇌졸중 환자, 특히 정중 전두엽이나 기저절 병변을 동반한 환자들의 경우에는 비록 그 병변이 측두엽 침범이 없거나 Kluver-Bucy syndrome의 전형적인 증상을 보이지 않는다 할 지라도 성욕등 성적 활동에 대한 체계적인 조사가 필요할 것으로 생각된다. 또한 과잉성욕 증상과 강박 증상을 함께 가지고 있는 경우 선택적인 세로토닌 재흡수 억제제의 사용이 두 증상 모두를 효과적으로 치료하는 데에 도움이 될 수 있을 것이다.

• 대한핵의학회지
• /
• 제32권5호
• /
• pp.397-402
• /
• 1998

목적: 대뇌피질의 구조적 병변이 없는 기저핵 혈종환자에 있어서, 대뇌와 소뇌의 해리 현상에 관해 알아보고자하였다. 대상 및 방법 : CT와 MRI상 혈종이 기저핵에 국한되고, 대뇌 피질의 구조적 병변이 없는 12명의 환자를 대상으로 하였다. Tc-99m ECD PECT검사가 전 예에서 시행되었고, 대조군으로 MRI상 구조적 병변이 없고 SPECT 검사상 육안적으로 정상 소견을 보인 20명의 정신과 환자가 선택되었다. 해리 현상에 의한 rCBF의 변화를 육안적으로 확인하였고, 반정량적 분석을 위해 asymmetric index (AI)를 이용하였다. AI가 기저핵, 시상, 소뇌와 대뇌 피질 (전두엽, 측두엽, 두정엽)에서 측정되었고, 대조군 AI의 (평균+2X표준편차)보다 큰 AI를 가지는 경우를 저혈류로 정의하였다. 결과: 환자군에서 측정된 소뇌와 대뇌 피질의 평균 AI는 대조군과 비교하여 통계학적으로 의미 있게 큰 수치를 보였다 (p<0.05): 소뇌 ($18.68{\pm}8.94$ vs $4.35{\pm}0.94$, 평균 표준표차), 시상 ($31.91{\pm}10.61$ vs $2.51{\pm}1.45$), 기저핵 ($35.94{\pm}16.15$ vs $4.34{\pm}2.08$), 두정엽 ($18.94{\pm}10.69$ vs $3.24{\pm}0.87$), 전두엽 ($13.60{\pm}10.8$ vs $4.02{\pm}2.04$), 측두엽 ($18.92{\pm}11.95$ vs $5.13{\pm}1.69$). 12명의 환자 중 혈종의 반대측 소뇌(10명), 동측 시상 (12명) 동측 두정엽 (12명), 전두엽 (6명), 측두엽 (10명)에서 육안적으로 또한 AI를 이용한 반정량적 분석상 의미 있는 저혈류를 보였다. 결론: 교차소뇌해리 현상과 피질 해리 현상은 기저핵 혈종 환자에서 빈번하게 관찰되었다. 이는 교차 소뇌해리 현상이 기존에 알려진 피질 뇌교 소뇌로 (corticopontocerebellar tract)의 장애가 없이도 발생할 수 있다는 것을 시사한다.

• 대한임상독성학회지
• /
• 제2권2호
• /
• pp.137-140
• /
• 2004

Acute cyanide poisoning is usually the result of attempted suicide which is often lethal within minutes or leads to a very poor prognosis after delayed and inadequate treatment. It affects the cerebral structures with the highest oxygen requirement, such as the basal ganglia, the cerebral cortex. We experienced a-45-year-old man who ingested Potassium Cyanide. He was stuporous. In 25 minutes, respiratory arrest developed and cardiopulmonary resuscitation was done. After return of spontaneous circulation, he admitted to intensive care unit, and conservative treatment was started. The clinical status was improved by degrees, but he couldn't perform daily activity like before. Minimal limitation of movement and memory deficit were left. In magnetic resonance imaging, which taken at the 11th day after admission, there were both basal ganglia and folia of cerebellum abnormality.

• Journal of Korean Neurosurgical Society
• /
• 제49권2호
• /
• pp.112-115
• /
• 2011

The intra-arterial administration of nimodipine (IAN) is commonly used for cerebral vasospasm refractory to medical treatments. We report two cases of vasogenic edema after IAN. Our patients with aneurismal subarachnoid hemorrhage presented with vasospasm, which was treated by IAN. Consequently, vasogenic edema developed in the basal ganglia. Reperfusion following IAN for vasospasm may have the potential for inciting vasogenic edema in the ischemic brain.