• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.35-44
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• 1991

Recently many authors have reported about the relationship of the volumes of hemorrhage in the brain parenchyme, hemorrhagic sites, optimal operation time, and the effects of mannitol and steroid on control of ICP to clinical manifestations. Many attempts to measue ICP in hydrocephalus, brain tumor, and head injury have been reported. But the measurements of intracranial pressure in spontaneous intracerebral hemorrhage are rare. Intracranial pressure was monitored prospectively in 30 patients who had stereotaxic surgery for spontaneous intracerebral hemorrhage. The results are as follows. 1. Intracranial pressure was increased in high $PaCO_2$. 2. There were no correlation in ICP, rebleeding and ADL at discharge(P > 0.05). 3. ICP was the most high level in 72 hours after operation. 4. There was 63.2% decrease in ICP after litigation with 6000 IU urokinase in the site of hemorrhage. 5. There was no correlation between the numbers of natural drainage and ADL at discharge(P > 0.05). 6. The higher the initial GCS, the higher the Postoperative GCS.

• The Journal of Internal Korean Medicine
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• v.31 no.4
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• pp.706-713
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• 2010

Objectives : The source is from the flower of Carthamus tinctorius L., family Compositae. It is used in clinical medicine to promote blood circulation, remove blood stasis, promote menstruation and alleviate pain. In the present study, we investigated the genome wide analysis of Carthami Flos on the intra-cranial hemorrhage(ICH) model. Methods : ICH in rat was induced by injection of collagenase type IV and Carthami Flos extract(CFe) was administered orally. The molecular profile of cerebral hemorrhage in rat brain tissue was measured using microarray technique to identify up- or down- regulated genes in brain tissue. Results : Expression profile showed that diverse genes were up- or down-regulated by ICH induction. Administration of CFe restored the expression level of some of altered genes by ICH to normal expressional level. Interestingly, these recovered genes by CFe were involved in the same biological pathways which were significantly activated or suppressed by ICH. Conclusion : The above results might explain the therapeutic mechanism of CFe on ICH. Further, by analyzing interaction network, core genes was identified which could be key molecular targets of CFe against ICH.

• Investigative Magnetic Resonance Imaging
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• v.19 no.3
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• pp.146-152
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• 2015

Purpose: The purpose of this study was to evaluate the associated brain parenchymal abnormalities of developmental venous anomalies (DVA) with susceptibility-weighted image (SWI). Materials and Methods: Between January 2012 and June 2013, 2356 patients underwent brain MR examinations with contrast enhancement. We retrospectively reviewed their MR examinations and data were collected as per the following criteria: incidence, locations, and associated parenchymal signal abnormalities of DVAs on T2-weighted image, fluid-attenuated inversion recovery (FLAIR), and SWI. Contrast enhanced T1-weighted image was used to diagnose DVA. Results: Of the 2356 patients examined, 57 DVAs were detected in 57 patients (2.4%); 47 (82.4%) were in either lobe of the supratentorial brain, 9 (15.7%) were in the cerebellum, and 1 (1.7%) was in the pons. Of the 57 DVAs identified, 20 (35.1%) had associated parenchymal abnormalities in the drainage area. Among the 20 DVAs which had associated parenchymal abnormalities, 13 showed hemorrhagic foci on SWI, and 7 demonstrated only increased parenchymal signal abnormalities on T2-weighted and FLAIR images. In 5 of the 13 patients (38.5%) who had hemorrhagic foci, the hemorrhagic lesions were demonstrated only on SWI. Conclusion: The overall incidence of DVAs was 2.4%. Parenchymal abnormalities were associated with DVAs in 35.1% of the cases. On SWI, hemorrhage was detected in 22.8% of DVAs. Thus, we conclude that SWI might give a potential for understanding of the pathophysiology of parenchymal abnormalities in DVAs.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.89-92
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• 2006

Penetrating facial wounds are uncommon and are usually life threatening because of the possibility of brain damage. There are three possible pathways for penetrating the cranium through the orbit: via the orbital roof, via the superior orbital fissure, or between the optic canal and lateral wall of the orbit. Brain injuries resulting from the penetrating wounds show extensive parenchymal damage, hemorrhage, and brain edema. Transorbital penetrating wounds can lead to diverse lesions of the optical apparatus, including the eye globe, the optical nerve, and the chiasm. Moreover, intracerebral structures may be hurt, and bleeding and infection may occur. Early diagnosis and prompt debridement are the fundamental factors affecting the outcome of a penetrating facial wound. An 87-year-old man was admitted to the emergency department with a grinder impacted into the medial aspect of the right eye. On presentation, the man was fully conscious with a Glasgow Coma Scale score of 15 and complained of a visual disturbance of the right eye. Computed tomography demonstrated a right orbital medial and inferior wall fracture, a frontal bone fracture, and a contusional hemorrhage in frontal lobe of the brain. A craniotomy with hematoma removal and repair of the orbital floor was done. He showed no neurological deficits except right visual loss. This appears to be the first report of a man with a penetrating facial wound caused by a grinder, who presented with a potentially disastrous craniocerebral injury that did not lead to any serious neurological seguelae.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.579-583
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• 2010

An 18-month-old intact male Pomeranian dog was presented because of traumatic head injury from a fall. Based on physical and neurological examination, brain injury was suspected. On plain skull radiographs, bony fragment following fracture was identified in the region of the right occipital bone. On computed tomography (CT) images, there were specific findings associated with an intracranial hemorrhage. The patient expired few hours after diagnosis, and performed necropsy. On gross findings, intracerebral hemorrhage and edema was detected and those were consistent with CT images. This report describes the clinical findings, CT imaging characteristics, necropsy findings, and histopathologic features of severe traumatic brain injury in a dog.

• 대한핵의학회:학술대회논문집
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• 1997.05a
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• pp.148-148
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• 1997

• The Journal of Korean Medicine
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• v.25 no.4
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• pp.95-107
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• 2004

Objective : The inappropriate or excessive apoptosis has been known to be associated with neurodegenerative disorders including intracranial hemorrhage(ICH). Paeoniae radix, in traditional Korean medicine, has played its role as blood­nourisher and yin-astringent. In the present study, the effect of Paeoniae radix on the inhibition of neurodegeneration in the brain of rats after artificial ICH and on the resulting apoptosis was investigated. Methods : 30 rats were divided into 6 equal groups ; the sham-operation group, the hemorrhage-induction group, the hemorrhage-induction with 10, 50, 100, and 200 mg/kg Paeoniae radix-treated group, respectively. Stereotactic surgery was performed and collagenase was infused to induce ICH in the region of CA1 of hippocampus of rats. The sham group took only saline infusion. For 7 days after the surgery, 4 testing groups had intraperitoneal injections of Paeoniae radix extract. The step-down inhibitory avoidance task, measurement of neurodegeneration degree in the CA1 region of the hippocampus, and detection of caspase-3 and newly generated cells in the dentate gyrus were done after animal sacrifice. Results : Rats receiving Paeoniae radix extract showed increased latency time in the inhibitory avoidance task. The extension of neuron-deprived areas in the CA1 region was significantly suppressed in the Paeonia treated groups. Also expressions of caspase-3 in the CA1 region and cortex were significantly inhibited in the Paeonia treated groups. The cell proliferation was evaluated by means of BrdU methods and proved to be decreased in the Paeonia treated groups. Conclusion : These results suggest that Paeoniae radix has potential to suppress short-tenn memory loss after devastating neurologic accidents. Also it was proved that Paeoniae radix has a neuroprotective effect and alleviates central nervous complications following intracerebral hemorrhage. Furthermore, it may imply that this medicinal plant can be widely used for vascular dementia and other neurodegenerative disorders.

• Journal of Korean Neurosurgical Society
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• v.30 no.12
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• pp.1375-1380
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• 2001

Objective : The authors analyzed the incidence, the cause and the prognosis of hydrocephalus following aneurysmal subarachnoid hemorrhage to evaluate the risk factors of hydrocephalus and to provide the proper treatment method for hydrocephalus following aneurysmal subarachnoid hemorrhage. Methods : The 505 cases of subarachnoid hemorrhage followed by aneurysmal surgery from January 1990 to May 1999, were divided into shunt group and shunt-free group and we were reviewed for the clinical status, Fisher's grade, brain CT findings and prognosis. Results : The incidence of acute hydrocephalus was 37.2% of patients and 18.9% to developed chronic hydrocephalus. Shunt surgery due to chronic hydrocephalus was required in 6.5% of patients. We found following variables were significantly related to shunt-dependent hydrocephalus : high Hunt-Hess and Fisher grade, initial CT findings of intraventricular hemorrahge, posterior circulation aneurysm, preoperative rebleeding, delayed ischemic deficits, and initial high ventricular size index. There were no statistically significant relationships between shunt-dependent hydrocephalus and patient age or sex, timing of operation. The previous hypertension was not related to shunt dependent hydrocephalus. Prognosis in shunt group showed poor result. Conclusion : The risk factors of hydrocephalus following aneurysmal subarachnoid hemorrhage are high Hunt-Hess grade, high Fisher's grade, aneurysms of posterior circulations, preoperative aneurysmal rebleeding, delayed ischemic deficits, initial CT findings of intraventricular hemorrahge and initially increased ventricular size. The patients with these factors should the carefully observed and managed accordingly due to poor prognosis related to hydrocephalus requiring shunt operation.

• Molecules and Cells
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• v.40 no.2
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• pp.133-142
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• 2017

Previous studies have shown that bone marrow mesenchymal stromal cell (MSC) transplantation significantly improves the recovery of neurological function in a rat model of intracerebral hemorrhage. Potential repair mechanisms involve anti-inflammation, anti-apoptosis and angiogenesis. However, few studies have focused on the effects of MSCs on inducible nitric oxide synthase (iNOS) expression and subsequent peroxynitrite formation after hypertensive intracerebral hemorrhage (HICH). In this study, MSCs were transplanted intracerebrally into rats 6 hours after HICH. The modified neurological severity score and the modified limb placing test were used to measure behavioral outcomes. Blood-brain barrier disruption and neuronal loss were measured by zonula occludens-1 (ZO-1) and neuronal nucleus (NeuN) expression, respectively. Concomitant edema formation was evaluated by H&E staining and brain water content. The effect of MSCs treatment on neuroinflammation was analyzed by immunohistochemical analysis or polymerase chain reaction of CD68, Iba1, iNOS expression and subsequent peroxynitrite formation, and by an enzyme-linked immunosorbent assay of pro-inflammatory factors (IL-$1{\beta}$ and TNF-${\alpha}$). The MSCs-treated HICH group showed better performance on behavioral scores and lower brain water content compared to controls. Moreover, the MSC injection increased NeuN and ZO-1 expression measured by immunochemistry/immunofluorescence. Furthermore, MSCs reduced not only levels of CD68, Iba1 and pro-inflammatory factors, but it also inhibited iNOS expression and peroxynitrite formation in perihematomal regions. The results suggest that intracerebral administration of MSCs accelerates neurological function recovery in HICH rats. This may result from the ability of MSCs to suppress inflammation, at least in part, by inhibiting iNOS expression and subsequent peroxynitrite formation.

• Journal of Korean Neurosurgical Society
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• v.57 no.5
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• pp.379-385
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• 2015

Chronic subdural hematomas mainly occur amongst elderly people and usually develop after minor head injuries. In younger patients, subdural collections may be related to hypertension, coagulopathies, vascular abnormalities, and substance abuse. Different techniques can be used for the surgical treatment of symptomatic chronic subdural hematomas : single or double burr-hole evacuation, with or without subdural drainage, twist-drill craniostomies and classical craniotomies. Failure of the brain to re-expand, pneumocephalus, incomplete evacuation, and recurrence of the fluid collection are common complications following these procedures. Acute subdural hematomas may also occur. Rarely reported hemorrhagic complications include subarachnoid, intracerebral, intraventricular, and remote cerebellar hemorrhages. The causes of such uncommon complications are difficult to explain and remain poorly understood. Overdrainage and intracranial hypotension, rapid brain decompression and shift of the intracranial contents, cerebrospinal fluid loss, vascular dysregulation and impairment of venous outflow are the main mechanisms discussed in the literature. In this article we report three cases of different post-operative intracranial bleeding and review the related literature.