• Journal of Korean Neurosurgical Society
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• 제46권3호
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• pp.257-260
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• 2009

Intraventricular hemorrhage long after successful encephaloduroarterio synangiosis (EDAS) is very rare. The effect of revascularization surgery for preventing hemorrhagic event of moyamoya disease remains controversial. We report a 17-year-old female with intracerebral hemorrhage and intraventricular hemorrahge 10 years after successful EDAS. Even though cerebral vessels angiography showed good collateral circulations without specific weak points, a cerebral hemorrhage could occur in patient with ischemic type of moyamoya disease long after successful indirect bypass operations. Good collateralization of cerebral angiography or magnetic resonance perfusion image after indirect bypass surgery would ensure against ischemic symptoms, not a hemorrhage. And, thus a life-time follow-up strategy might be necessary even if a good collateral circulation has been established.

• Brain & NeuroRehabilitation
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• 제10권1호
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• pp.1-6
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• 2017

The brain necrosis induced by radiation therapy (RT) is an uncommon pathology of brain. A case of spontaneous hemorrhage at necrotic brain is also rare. A 52-year-old man who had nasopharyngeal carcinoma and had been treated with RT, presented with gait disturbance, dizziness, ataxia, dysarthria, and dysphagia. Magnetic resonance imaging (MRI) demonstrated progressed radiation necrosis of pons, and spontaneous hemorrhage at the site of necrosis. The hematoma was diminished by conservative treatment. However, the patient's neurologic symptoms did not recover. Two years later, spontaneous bleeding recurred at necrotic brain. His neurologic symptoms worsened. One year later, his neurologic symptoms were more progressed. He showed severe dysphagia, profound weakness and respiratory failure. This case provides the description of relapsed spontaneous hemorrhage and medullary dysfunction caused by pontine necrosis and progressed post-radiation injury, complicated with hemorrhage, and urges caution in that the necrotic brain tissue may be vulnerable to bleeding.

• Radiation Oncology Journal
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• 제33권1호
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• pp.36-41
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• 2015

Purpose: To evaluate the incidence and risk factors of post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma (HCC). Materials and Methods: Medical records of 81 patients who have been diagnosed of brain metastases from HCC and underwent surgery, radiosurgery and/or whole brain radiotherapy (WBRT) between January 2000 and December 2013 were retrospectively reviewed. Results: Intracranial hemorrhage was present in 64 patients (79%) at the time of diagnosis. Median value of alpha-fetoprotein (AFP) level was 1,700 ng/mL. The Eastern Cooperative Oncology Group (ECOG) performance status for 20 patients was greater than 2. Fifty-seven patients underwent WBRT and the others were treated with surgery and/or radiosurgery without WBRT. During follow-up, 12 events of intracranial hemorrhage after treatment were identified. Three-month post-treatment hemorrhage rate was 16.1%. Multivariate analyses revealed that ECOG performance status, AFP, and WBRT were associated with post-treatment hemorrhage (p = 0.013, 0.013, and 0.003, respectively). Kaplan-Meier analysis showed that 3-month post-treatment hemorrhage rate of new lesion was higher in patients treated without WBRT, although statistical significance was not reached. (18.6% vs. 4.6%; p = 0.104). Ten of 12 patients with post-treatment hemorrhage died with neurologic cause. Conclusion: WBRT should be considered to prevent post-treatment hemorrhage in the treatment of brain metastases from HCC.

• 동의생리병리학회지
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• 제27권6호
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• pp.789-794
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• 2013

Hemorrhage is a devastating type of stroke, accounts for 15-20% of all strokes. This disease can cause cognitive dysfunction with a very high mortality rate. Cupping therapy of Traditional Korean medicine has frequently been used to relieve a variety of diseases or clinical conditions, although not in the memory loss after hemorrhage. This study was designed to evaluate the effects of cupping therapy on learning and memory with Y-maze test, as well as its effects on different molecular changes in hippocampus following the induction of hemorrhage in rats. Cupping, using vacuum cupping machine, was applied at target area for 5 min daily for 7 consecutive days, commencing 1 day after brain impairment. As a result, induction of hemorrhage enhanced memory deficit, suppressed brain-derived neurotrophin factor (BDNF) in the hippocampus. Cupping treatment effectively reversed collagenase-induced cognitive impairment in SD rats which was represented by improvement of spontaneous alterations in Y-maze test. In addition, BDNF expression was enhanced after cupping therapy. The present results suggest that the therapeutic effects of cupping treatment after hemorrhage is involved in expression of BDNF.

• 한국방사선학회논문지
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• 제16권1호
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• pp.25-34
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• 2022

뇌 전산화단층촬영은 비침습성, 3차원 영상 제공, 저방사선량 등의 장점 때문에 뇌출혈과 같은 질병 진단을 위해 시행된다. 하지만 뇌 전산화단층영상 판독을 위한 전문의의 인력 공급 부족 및 막대한 업무량으로 인해 수많은 판독 오류 및 오진이 발생하고 있다. 이와 같은 문제를 해결하기 위해 객체 검출을 위한 다양한 인공지능 기술이 개발되고 있다. 본 연구에서는 뇌 전산화단층영상으로부터 뇌출혈 검출을 위한 딥러닝 기반 YOLOv5s 모델의 적용 가능성을 확인하였다. 또한 YOLOv5s 모델 학습 시 초매개변수를 변화시켜 학습된 모델의 성능을 평가하였다. YOLOv5s 모델은 backbone, neck 및 output 모듈로 구성하였고, 입력 CT 영상 내 뇌출혈로 의심되는 부위를 검출하여 출력할 수 있도록 하였다. YOLOv5s 모델 학습 시 활성화함수, 최적화함수, 손실함수 및 학습 횟수를 변화시켰고, 학습된 모델의 뇌출혈 검출 정확도 및 학습 시간을 측정하였다. 연구결과 학습된 YOLOv5s 모델은 뇌출혈로 의심되는 부위에 대한 경계 박스 및 해당 경계박스에 대한 정확도를 출력할 수 있음을 확인하였다. Mish 활성화함수, stochastic gradient descent 최적화함수 및 completed intersection over union 손실함수 적용 시 YOLOv5s 모델의 뇌출혈 검출 정확도 향상 및 학습 시간이 단축되는 결과를 확인하였다. 또한 YOLOv5s 모델의 뇌출혈 검출 정확도 및 학습 시간은 학습 횟수에 비례하여 증가하는 결과를 확인하였다. 따라서 YOLOv5s 모델은 뇌 전산화단층영상을 이용한 뇌출혈 검출을 위해 활용할 수 있으며, 최적의 초매개변수 적용을 통해 성능을 향상 시킬 수 있다.

• Journal of Korean Neurosurgical Society
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• 제46권1호
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• pp.23-30
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• 2009

Objective : Clinical features of pituitary hemorrhage vary from asymptomatic to catastrophic. The purpose of this study was to evaluate the factors related to severity of hemorrhage of pituitary adenoma. Methods : Pituitary hemorrhage was noted in 32 of 88 patients who underwent operations between January 2000 and December 2007. Clinical status was classified into group I (no hemorrhage symptoms), II (mild to moderate symptoms without neurological deficit), and III (with neurological deficit), and was compared to radiological, pathological, and operative findings. All patients were operated by transsphenoidal approach, and hemorrhage-related symptoms were relieved. Results : Groups I, II,and III comprised 15, 10 and 7 patients, respectively. In group I, hemorrhage volume was under 1 mL in 11 (73.3%), but, it was above 1 mL in 7 (70%) of group II and in all cases of group III. Hemorrhage stage based on MRI findings was chronic or subacute in 11 (73.3%) of group I, acute in 6 (60%) of group II, and acute or hyperacute in 6 (85.7%) of group III. Pathological examination revealed chronic-stage hematomas in 5 (50%) group II patients. Functioning adenomas were found in 5 (33.3%) group I patients but none in group II or III patients. Silent adenomas were found in 4 (26.7%), 8 (80%), and 3 (42.9%) in groups I, II,and III, respectively. Conclusion : Clinical features of pituitary hemorrhage may differ with the radiological and immunohistopathlogical findings. Persistent symptoms are related to the chronic stage of hematoma requiring surgery for symptom relief. Neurological deficits are caused by large amount of acute hemorrhage requiring emergency operation. Silent adenoma is related to the severity of pituitary hemorrhage.

• 한국응급구조학회지
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• 제24권2호
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• pp.99-109
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• 2020

Purpose: Alcohol intoxication is frequently observed in patients with brain hemorrhage. The purpose of this study was to determine whether intoxication affects the Korean Triage and Acuity Stage (KTAS) level and the emergency medical process in emergency departments. Methods: This study was a retrospective observational study enrolled 253 brain hemorrhage patients (47 of those intoxicated) who visited the emergency medical center on public EMS ambulance from January. 1, 2017 to April, 30, 2019. Data were collected through the electronic medical record (EMR). KTAS level and time to computerized tomography (CT) were compared to evaluate whether inebriation affects care and examination processes. All data were analyzed using SPSS program. Results: Of the 47 patients intoxicated patients, 85.1% were male, and 74.5% accompanied by trauma. Initial KTAS level showed significant differences (77.2%; p=.000) when the level 3,4 was not drunk. The average time taken from triage to CT scans showed a significant difference of 24.81±23.72 (min) when the drunken state was not 58.38±56.54 (min)(p=.000). Conclusion: In patients with brain hemorrhage admitted to ED from public EMS, undertriage and delay after initial assessment were detected in inebriated patients. Careful initial evaluation and prompt medical response should be considered for patients transported by EMS.

• Journal of Acupuncture Research
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• 제20권2호
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• pp.29-41
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• 2003

Clinical observation was made on 52 cases of Stroke that were confined through brain CT, MRI scan. The Stroke cases wee classified into the following kinds cerebral infarction, cerebral hemorrhage, cerebellar or brain stem infarction, cerebellar or brain stem hemorrhage. And among the 52 cases of Stroke cerebral infarction was noticed in 75.00%, cerebral hemorrhage in 11.54%, cerebellar or brain stem infarction in 9.52%, cerebellar or brain stem hemorrhage in 3.85%. The ratio between males and females was 1.74:1 in the whole groups of Stroke and most cases were over 60 of age. As the time of hospitalization, most patients hospitalized from 1 day after stroke to 7 days after stroke. And as the course of hospitalization, most patients hospitalized first. Among the preceding disease at the onset of Stroke hypertention was noted in 32.69%, and deabetes mellitus or heart problem was noted frequently(15.39%). Electrocardiography findings were as follows: The normal was noted in 53.85%, the abnormal in 46.15%. And as the abnormal, left ventricular hypertrophy was noted in 17.54%. The predisposing factors or conditions at the onset of brain infarction were usually initiated during the time of sleeping and those of brain hemorrhage chiefly during the time of exercising like overwork or walking etc. It was noted that smoking a pack of cigarette showed highest disease rate(33.33%) among the average of smoking amount of one day in case of man. Prior to attack, the most chiefly complain was dyspnea or discomfort on chest region. And 30.70% of patients had no previous sign. There were a large number of recurrent cases. The first attack was noted in 71.15%, the 2nd attack in 23.08%, the 3rd attack in 5.77%.

• Investigative Magnetic Resonance Imaging
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• 제20권1호
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• pp.71-74
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• 2016

Wernicke's encephalopathy (WE) is an acute neurological disorder resulting from thiamine deficiency. Early diagnosis and treatment of WE is important to avoid persistent brain damage. Although histopathologic examination usually demonstrates pin-point hemorrhages in affected brain parenchyma, secondary hemorrhage is a rare but serious complication of WE. We experienced a rare case of intracranial hemorrhage related to WE in a 56-year-old male patient with malnourishment.

• Korean Journal of Radiology
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• 제2권2호
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• pp.105-107
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• 2001

Meningiomas causing intracranial hemorrhage are rare, and hemorrhage from a lateral ventricular meningioma seems to be even rarer. We report a case of trigonal meningioma in a 43-year-old woman who presented with intraventricular hemorrhage, and describe the CT, MRI and angiographic findings.