• Journal of Sasang Constitutional Medicine
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• v.22 no.4
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• pp.30-39
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• 2010

1. Objectives This study was carried out to investigate the equilibrium functional difference according to mean velocity of basilar artery with Sasang Constitution. 2. Methods We analyzed the data of 300 adults(194 males, 106 females), who visited oriental hospital of D university for medical examiation, which includes Sasang constitution examination, equilibrium function test, transcranial doppler ultrasonography(TCD). We evaluated the trace length and envelop area of open eyes and closed eyes, mean velocity of basilar artery and analyzed its statistical data. 3. Results and Conclusions 1) Within all subjects, trace length and envelop area of closed eyes were significantly lower, in the order of increased mean velocity of basilar artery group, normal mean velocity of basilar artery group and decreased mean velocity of basilar artery group. 2) No significantly difference was seen between the mean velocity of basilar artery and equilibrium function in Soyangin and Soeumin. 3) When closed eyes, trace length were significantly lower in order of increased mean velocity of basilar artery group, normal mean velocity of basilar artery group and decreased mean velocity of basilar artery group, in Taeeumin.

• Journal of Korean Neurosurgical Society
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• v.40 no.1
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• pp.31-34
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• 2006

This 58-year-old woman was transferred from a local hospital due to symptoms of acute headache and decreased consciousness. Computed tomography revealed a subarachnoid hemorrhage with blood clot in prepontine cistern. On the first day in the hospital, diagnostic cerebral angiography revealed a basilar tip aneurysm. We performed basilar artery to bilateral posterior cerebral artery[PCA] stent placement to reconstruct the basilar artery apex.

• Journal of Korean Neurosurgical Society
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• v.56 no.5
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• pp.428-430
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• 2014

Isolated traumatic pseudoaneurysms of the basilar artery are extremely rare but often fatal resulting in a mortality rate as high as 50%. A 51-year-old man presented with craniofacial injury after blunt trauma. A brain computed tomography (CT) scan showed thick basal subarachnoid hemorrhage associated with multiple craniofacial fractures, while CT angiography revealed contrast extravasation at the distal basilar artery with pseudoaneurysm formation. After this primary survey, the condition of the patient suddenly deteriorated. Conventional angiography confirmed the contrast extravasation resulted from pseudoaneurysm formation, which was successfully treated with endovascular coil embolization. Decompressive craniectomy and coma therapy with propofol were also performed. However, the patient died on the 7th hospital day because of the poor initial clinical condition. The current case is the first report of acute pseudoaneurysm rupture arising from the basilar artery within the first day after trauma. Our findings suggest the possibility that pseudoaneurysm rupture should be considered if brain CT shows thick traumatic subarachnoid hemorrhage on the basal cistern with a basal skull fracture.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.400-404
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• 2016

We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA. Because the volume of infarction in the territory of the right MCA was extensive, we judged the use of intravenous tissue plasminogen activator to be contraindicated. Cerebral angiography revealed hypoplasia of both vertebral arteries and the presence of a PPTA from the right internal carotid artery. A microcatheter was introduced into the BA via the PPTA and revascularization was successfully performed using a Merci Retriever with adjuvant low-dose intraarterial urokinase. After treatment, his consciousness level and right motor weakness improved. Although persistent carotid-vertebrobasilar anastomoses such as a PPTA are relatively rare vascular anomalies, if the persistent primitive artery is present, it can be an access route for mechanical thrombectomy for acute ischemic stroke.

• Journal of Korean Neurosurgical Society
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• v.29 no.4
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• pp.451-460
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• 2000

Objective : This experiment is aimed at clarifying the characteristics of spasmodic basilar arteries in the rabbits of subarachnoid hemorrhage(SAH) with observation of vascular response to nitric oxide(NO) and endothelin-1. Material and Methods : Seventy-nine New Zealand white rabbits were divided into 4 groups : control(n=17), sham operation(n=13), postictal-2-day(n=25), and postictal-7-day group(n=24). Rabbits in the postictal-2-day group and postictal-7-day group underwent transfemoral vertebral angiography 2 days and 7 days after SAH respectively. A vascular ring of spasmodic basilar artery was harvested and suspended in organ chamber($37^{\circ}C$) to observe isometric tension changes in response to NO and endothelin-1 under both high(95% $O_2$/5% $CO_2$) and low(95% $N_2$/5% $CO_2$) $O_2$ tension. To investigate the vascular response to NO, acetylcholine from $10^{-7}M$ to $3{\times}10^{-4}M$ concentration was applied to basilar artery ring precontracted with histamine $10^{-6}-10^{-5}M$ in the organ chamber. The vascular response to endothelin-1 was observed by applying endothelin-1 from $10^{-11}M$ to $3{\times}10^{-8}M$ concentration into organ chamber. Results : Seven of 15 live rabbits which underwent angiography 2 days after SAH, were confirmed to develop vasospasm($64.3{\pm}11.2%$) whereas seven of 13 live rabbits which underwent angiography 7 days after SAH, were confirmed to develop vasospasm($64.9{\pm}10.9%$). In all groups, hypoxia significantly reduced the vascular relaxation of basilar arteries to NO. However, hypoxia made no influence on the vascular contraction of basilar arteries to endothelin-1 in all groups. In vascular relaxation of basilar arteries to NO under high $O_2$ tension between groups, the maximum relaxation of basilar arteries in the postictal-7-day group was significantly reduced compared to the postictal-2-day group. In vascular contraction of basilar arteries to endothelin-1 under high $O_2$ tension between groups, the maximum contraction of basilar arteries in the postictal-7-day group was significantly reduced compared to the postictal-2-day group. Conclusions : This experiment suggests that the characteristics of vascular response to NO and endothelin-1 in the spasmodic basilar arteries of rabbits observed 2 days after SAH is different from those observed 7 days after SAH.

• The Journal of Korean Medicine
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• v.20 no.2
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• pp.146-156
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• 1999

The present study was performed to investigate the effect of Yangkyuksanhoa-tang on the morphological changes of the basilar artery after experimentally induced subarachnoid hemonrrhages(SAH). Yangkyuksanhoa-tang has been used freguently for cerebrovascular accident Sprague Dawley rats weighing between 350-400 g were used. The 6 normal rats and 24 SAH elicited rats were used, The SAH induced by injection of the fresh autologus heart blood (0.3-0.4 ml) into the cisterna magna through the posterior atlanta-occipital membrane, Sample group was given 3.3 ml/kg/day of Yangkyuksanhoa-tang extracts for 2 days after SAH. The experimental animals were killed at 48hrs after SAH. The morphological changes of the arterial walls were examined by light and electron microscopy. Following are the obtained results: 1. In SAH elicited rats, the size of the lumen in basilar artery was diminished by about 45% and the thickness of arterial wall was increased by about 82%. In SAH elicited rats with Yangkyuksanhoa-tang treatment, the size of the lumen in basilar artery was merely diminished by about 18% and the thickness of arterial wall was merely increased by about 19%. 2. In light microscopic examination, the endothelium was swollen into a cuboid shape and the layer of smooth muscle was increased in the basilar artery of SAH elicited rats. In SAH elicited rats with Yangkyuksanhoa-tang treatment, the size of the lumen in basilar artery was enlarged and the thickness was decreased than in SAH elicited rats. The endothelium was flattened into a squamous shape and the layer of smooth muscle was decreased more than in SAH elicited rats. 3. In electron microscopic examination, the endothelial cells with fragmentation nuclei were changed into a cuboid shape and the internal elastic lamina were folded at the basilar artery of SAH elicited rat. The nuclei of smooth muscle cells were changed into a round or crumpled shape. The length of smooth muscle was shorten and thickness was increased. But all kinds of morphologic changes were diminished in SAH elicited rats with Yangkyuksanhoa-tang treatment. Conclusion : Yangkyuksanhoa-tang extracts were effective to treat cerebral vasospasm after experimentally induced subarachnoid hemorrhage in rats.

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.101-104
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• 2005

Objective: A persistent trigeminal artery (PTA) may be found incidentally on conventional cerebral angiography and magnetic resonance(MR) angiography. Our goal is to examine the course and relationships of the vessel to the surrounding structures. Methods: Cerebral angiography was performed in 494 patients and MRA in 880; the patients had or were suspected to have cerebrovascular disease. In the images, the incidence, origin, course, and relationships of the PTA were evaluated. Results: A PTA was found in two (0.4%) of the patients undergoing cerebral angiography and three (0.34%) receiving an MR angiography. In four patients, the PTA arose from the lateral part of the cavernous segment of the internal carotid artery, then passed caudally and around the base of the dorsum sellae. In the other patient, the PTA arose from the medial aspect of the siphon, and ascended sharply to pierce the dorsum sellae and join the basilar artery. In four cases, there was hypoplasia of a proximal basilar artery below the abnormal communication; the vessel was of increased diameter above the communication. Conclusion: Identification of a PTA with a trans-sellar course is crucial if trans-sphenoidal surgery is planned. Hypoplasia of a proximal basilar artery should not be mistaken for an acquired narrowing.

• The Journal of Korean Physical Therapy
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• v.14 no.4
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• pp.119-130
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• 2002

The purpose of this study was to evaluate hemodynamics of intracranial blood flow for obtain clinically useful reference values and assess cerebral hemodynamics change with aging. 81 normal Korean subjects(age, 14$\thicksim\∼\thicksim$70 years) examined who han no history of neurologic disease and the subjects divided into group A(age, 14$\∼$39 years), group B(age, 40$\∼$59 years) and group C(age, 60$\∼$70 years). Transcranial doppler was use for measured the maximum velocity(Vmax), mean velocity(Vmean), pulsatility index(PI), resistive index(RI), stenosis index(SI) and depth of sample volume. Vmax was 99.1 1cm/s, Vmean was 63.57cm/s, PI was 0.85, RI was 0.56, SI was 31.94 and depth of sample volume was 52.35 in middle cerebral artery. Vmax was 85.54cm/s, Vmean was 52.52cm/s, PI was 0.82, RI was 0.55, SI was 34.48 and depth of sample volume was 73.62 in anterior cerebral artery. Vmax was 75.45cm/s, Vmean was 45.60cm/s, PI was 0.82, RI was 0.58, SI was 36.14 and depth of sample volume was 62.35 in posterior cerebral artery. Vmax was 70.44cm/s, Vmean was 47.07cm/s, PI was 0.87, RI was 0.58, SI was 29.83 and depth of sample volume was 75.23 in basilar artery Vmax was 63.92, Vmean was 42.42, PI was 0.89, RI was 0.58, SI was 29.89 and depth of sample volume was 66.65 in vertebral artery. Vmax and Vmean was significantly decreased with increasing age in middle cerebral artery, anterior cerebral artery, posterior cerebral artery, basilar artery and vertebral artery And PI and RI was significantly increased with increasing age in basilar artery and vertebral artery. And I suggest that transcranial doppler sonography can be used as one of useful clinical tool for detection of cerebral hemodynamics.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.4
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• pp.477-483
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• 2018

Transcranial doppler is a non-invasive method that measures the blood flow velocity and the direction of cerebral blood vessels through the doppler principle. The pulsatility index is an index for measuring the transcranial doppler that reflects the distal vascular resistance and is used as an index for the presence and diffusion of cerebral small vessel diseases. The purpose of this study was to evaluate the risk factors affecting the basilar artery pulsatility index in ischemic stroke patients. From January 2014 to May 2015, 422 patients were selected by measuring the transcranial doppler pulsatility index, considering their basilar artery pulsatility index. Univariate analysis was performed using the basilar artery pulsatility index as a dependent variable. Multiple regression analysis was performed considering the factors affecting the pulsatility index as variables. Univariate analysis revealed age, presence of hypertension, presence of diabetes mellitus, presence of hyperlipidemia, and hematocrit (P<0.1) as factors. Multiple regression analysis showed statistically significant results with age (P<0.001), presence of diabetes (P=0.004), and presence of hyperlipidemia (P=0.041). The risk factors affecting the basilar artery pulsatility index of transcranial doppler were age, diabetes, and hyperlipidemia. Further research will be needed to increase the cerebral pulsatility index as a surrogate marker of the elderly, diabetes, and hyperlipidemia.

• Journal of the Korean Society of Radiology
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• v.15 no.1
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• pp.29-35
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• 2021

The purpose of this study was to investigate whether there is a difference in image quality before and after reducing the amount of contrast medium in cerebral hemorrhagic patients who periodically follow up CT, and after reducing the amount of contrast medium, the image before and after reduction was examined, and the image quality was assessed by setting ROI at each vessel location using MMWP program. First Rt. CCA, Lt.CCA. Rt.MCA, Lt.MCA and Basilar Artery each got an ROI. Second, the mean and standard deviation values for the ROI were obtained. Third, SNR and CNR were obtained through the average and standard deviation values obtained. T-test statistics show that the SNR and CNR values obtained show that the result values for SNR are Rt.CCA 0.765, Ltd.CCA 0.871, Rt.MCA 0.343 LT.MCA 0.235, Basilar alternative 0.916, result value for CNR Rt.CCA 0.088, Ltd.CCA 0.069, Rt.MCA 0.818, Let's...MCA 0.579 and Basilar Artery 0.878. The results obtained through the obtained SNR and CNR values showed no difference in the quality of the images before and after reducing contrast medium. Therefore, we hope that this study will be an indicator that reduces the burden on contrast agents on patients who do CT examinations periodically.