• Journal of Trauma and Injury
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• v.29 no.4
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• pp.99-104
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• 2016

Purpose: There are many patients visited to ED in an alcohol intoxicated state. For these patients, it is difficult to predict by only clinical examination whether he/she would have brain lesion. The purpose of this study is to research whether it is possible to predict brain lesion by only clinical examination findings, with comparing patients with/without actual brain lesions. Methods: A retrospective study was performed at a university hospital for the period 11 months with the medical records. As for the inclusion group, head trauma patients with objectively proved drunk, judging by their blood ethanol concentration, and performed the brain CT were selected. In terms of medical record, Glasgow coma scale (GCS), the presence of neurologic abnormalities, the presence of lesion on brain CT of the patients, were examined. From laboratory results, blood ethanol concentration, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT) and glucose concentration were identified. Results: For this study, there were total 80 patients of inclusion group. There was no statistically significant difference in terms of GCS score and neurological examination abnormalities, between the group with brain lesion and the group without brain lesion on brain CT. Conclusion: Alcohol intoxicated patient with head trauma visits the ED, it is not possible to distinguish or determine whether brain lesion exists or not by only clinical findings. In order to check the lesion existence, the image examination, therefore, should be considered and performed.

• Korean Journal of Radiology
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• v.24 no.3
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• pp.247-258
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• 2023

Objective: To localize the neuroanatomical substrate of rapid eye movement sleep behavior disorder (RBD) and to investigate the neuroanatomical locational relationship between RBD and α-synucleinopathy neurodegenerative diseases. Materials and Methods: Using a systematic PubMed search, we identified 19 patients with lesions in different brain regions that caused RBD. First, lesion network mapping was applied to confirm whether the lesion locations causing RBD corresponded to a common brain network. Second, the literature-based RBD lesion network map was validated using neuroimaging findings and locations of brain pathologies at post-mortem in patients with idiopathic RBD (iRBD) who were identified by independent systematic literature search using PubMed. Finally, we assessed the locational relationship between the sites of pathological alterations at the preclinical stage in α-synucleinopathy neurodegenerative diseases and the brain network for RBD. Results: The lesion network mapping showed lesions causing RBD to be localized to a common brain network defined by connectivity to the pons (including the locus coeruleus, dorsal raphe nucleus, central superior nucleus, and ventrolateral periaqueductal gray), regardless of the lesion location. The positive regions in the pons were replicated by the neuroimaging findings in an independent group of patients with iRBD and it coincided with the reported pathological alterations at post-mortem in patients with iRBD. Furthermore, all brain pathological sites at preclinical stages (Braak stages 1-2) in Parkinson's disease (PD) and at brainstem Lewy body disease in dementia with Lewy bodies (DLB) were involved in the brain network identified for RBD. Conclusion: The brain network defined by connectivity to positive pons regions might be the regulatory network loop inducing RBD in humans. In addition, our results suggested that the underlying cause of high phenoconversion rate from iRBD to neurodegenerative α-synucleinopathy might be pathological changes in the preclinical stage of α-synucleinopathy located at the regulatory network loop of RBD.

• The Journal of Korean Medicine
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• v.18 no.2
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• pp.316-325
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• 1997

In a 36-month period, 23 selected Patients with Acute Cerebral Infarction were studied utilizing Computerized Tomography, Barthel Index in an attempt to correlate Brain Computerized Tomography findings with 1week, 4weeks rehabilitation and evaluate the influences of the size and location of the lesion. The study suggested that the size of the lesion had impact on 4 weeks rehabilitation. There was significant different between the patients with Middle Cerebral Artery Pial Territory Infarction(I.P.B.M.C.A.) lesion and the patients with Lacunar Infarction(L.I.), Striatocapsular Infarction(S.C.I.), Internal Watershed Infarction(I.W.I.) lesion, but there was no significant difference between the patients with L.I. lesion and the patients with S.C.I. lesion and the patients with I.W.I. lesion. The size and location of the lesion should be considered together in predicting the functional outcomes of Acute Cerebral Infarction.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.37-37
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• 2003

To assess the merits and demerits of postcontrast fat-suppressed (FS) brain MR imaging in children in the evaluation of various enhancing lesions, compared with postcontrast conventional or Magnetization Transfer (MT) imaging. 대상 및 방법： We reviewed patients with enhancing lesion on brain MR imaging who underwent both FS imaging and one of conventional or MT imaging as a postcontrast T1-weighted brain MR imaging. Inclusion criteria of our study were as follows： MR studies should be peformed within one-year interval and showed no significant interval change of imaging findings. Thirty-four patients (21 male, 13 female; mean age, 8 years) with 43 enhancing lesions (19 intra-axial, 19 extra-axial, and 5 orbital location) were included in this study, Twenty-one pairs of FS and conventional imaging, and 15 pairs of FS and MT imaging were available. Two radiologists visually assessed the lesion conspicuity and the presence of flow or susceptibility artifacts in a total of 36 pairs of MR imaging by consensus. For 21 measurable lesions (19 pairs of FS and conventional imaging, 5 pairs of FS and MR imaging), contrast ratio between the lesion and the normal brain( ［SIlesion-SIwater］/[SInormal brain-SIwater]) were calculated and compared.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.2
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• pp.93-96
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• 2014

Brain disorder disability is assessed when organic brain lesion such as cerebral palsy, traumatic brain injury, or stroke causes physical impairment which limits daily activites substantially according to its level and range of paralysis or the presence of involuntary movement. According to the disabled person welfare law in Korea, grade I brain disorder is assessed when one is in continuous irreversible state of coma without the ability to prolong one's life without other's help. Self-injurious behavior is defined as the non-suicidal intentional or unintentional injury to one's own body which can occur repetitively temporarily or chronically. People with decreased consciousness often exhibit increased self-injurious behavior which is most commonly associated with tongue or lip biting. This report documents a successful self -injurious lip biting treatment of a brain lesion patient within a short time by applying a removable acrylic resin appliance including posterior bite block.

• Annals of Clinical Neurophysiology
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• v.2 no.1
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• pp.13-20
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• 2000

Background and Objective : Visual evoked potentials(VEPs) is considered to be a reliable diagnostic procedure for examining patients with anterior visual pathways. Some abnormalities in the recordings on monocular stimulation have been said to indicate retrochiasmal lesion, but less consistent results have been reported. This study is to evaluate the positive predictability of VEP for the detection of retrochiasmal lesion. Methods : We reviewed VEPs that could be interpreted as indicative of a retrochiasmal lesions, based on amplitude or latency asymmetry recorded on the left(O1) and right(O2) occipital regions. Bilateral absent VEPs on both recording(O1 and O2) without evidence of prechiasmal lesion were included. During 5 years, we identified 31 patients who met the above criteria and who had undergone magnetic resonance imaging(MRI) of brain(one patient underwent computerized tomography). Twenty three patients underwent pattern reversal VEPs and others underwent flash goggle VEPs. Results : Brain imagings were abnormal in 29 and were normal in 2. Of the 29 abnormal scans, lesions in posterior visual pathway were detected in 21 scans(predictive value=68%). The predictive value was not significantly different between flash goggle VEP(75%) and pattern reversal VEP(68%). The predictive value was higher in patient with visual field defect(100%) than those without visual field defect(25%). The pathologic nature of lesion also showed close relations to the predictive value. VEPs is usually paradoxically lateralized(78%), but not in all patients. Conclusion : VEPs abnormalities suggesting retrochiasmal lesion were usually corresponded with brain MRI findings. Diagnostic reliability could be increased when considering the visual field defect and nature of lesion. Therefore, the authors suggest that VEPs studies could be useful in evaluating the patients with the retrochismal lesion.

• Journal of Veterinary Clinics
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• v.35 no.5
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• pp.178-183
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• 2018

The object of this study was to compare magnetic resonance imaging (MRI) findings and neurological signs in canine brain diseases. Brain diseases can cause severe neurological deficits and may be life-threatening. The antemortem diagnosis of the brain diseases is difficult for the clinician, since definitive diagnosis is based upon histopathological confirmation. Brain diseases are often associated with specific clinical signs, signalment, progression, and location. Accurate lesion localization through neurological examination and MRI findings is helpful for developing a differential diagnosis. A retrospective study was performed to compare the neurological examination of dogs with suspected brain disease to the MRI findings. Based on this study, neurological examination is a reliable way to localize most brain lesions. Postural reaction deficits do not provide sufficient information to localize lesions. Additionally, not all brain lesions present clinical signs and inflammatory lesions may cause no detectable abnormalities on MRI. Therefore, in clinical practice, a combination of neurological examination and MRI findings recommended for accurate brain lesion localization.

• Investigative Magnetic Resonance Imaging
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• v.3 no.1
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• pp.60-65
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• 1999

Purpose : The purpose of this study was to evaluate the image quality, contrast characteristics, and possible clinical utility of Medium Tau Inversion Recovery(MTIR) sequence with white matter suppression in patients with brain cortical lesion. Materials and methods : Two normal volunteers and twenty-one patients with cortical lesion were scanned with MTIR as well as other MR imaging sequences. Gray-white matter contrast was evaluated objectively using region-of-interest calculations, including percent contrast and contrast-to-noise ratio(CNR). MTIR sequence was visually compared with other sequences in 21 patients with cortical lesion including conspicuity and detection rate. Results : MTIR sequence had the highest present contrast and CNR between the gray matter and white matter. In twenty-one cases of cortical lesion including cortical dysplasia, MTIR sequence improved delineation and conspicuity of lesion, but MTIR sequence could not detect new lesions. Conclusion : The MTIR sequence well delineated the cortical lesions, particularly in including cortical dysplasia. It may be used as an adjunctive imaging sequence in case of poor gray and white matter differentiation with conventional T1-weighted sequences.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.509-512
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• 2014

Primary intraosseous meningioma is a rare tumor, and atypical pathologic components both osteolytic lesion and dura and soft tissue invasion is extremely rare. A 65-year-old woman presented with a 5-month history of a soft mass on the right frontal area. MR imaging revealed a 4 cm sized, multilobulated, strongly-enhancing lesion on the right frontal bone, and CT showed a destructive skull lesion. The mass was adhered tightly to the scalp and dura mater, and it extended to some part of the outer and inner dural layers without brain invasion. The extradural mass and soft tissue mass were totally removed simultaneously and we reconstructed the calvarial defect with artificial bone material. The pathological study revealed an atypical meningioma as World Health Organization grade II. Six months after the operation, brain MR imaging showed that not found recurrence in both cranial and spinal lesion. Here, we report a case of primary osteolytic intraosseous atypical meningioma with soft tissue and dural invasion.

• Tuberculosis and Respiratory Diseases
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• v.78 no.2
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• pp.112-119
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• 2015

Primary thymic adenocarcinoma is a very rare malignancy of the anterior mediastinum with no standardized treatment. A 36-year-old male patient presented with hoarseness over the past 3 months. A chest computed tomography (CT) scan showed an infiltrative mass to the proximal vessels and aortic arch in left upper mediastinum ($4.1{\times}3.1{\times}5.4cm$). Brain magnetic resonance imaging (MRI) showed focal lesions, suggesting metastasis in the left frontal lobe. A thoracoscopic biopsy of the mediastinal mass confirmed a primary thymic adenocarcinoma forming a glandular structure with atypia of tumor cells. The patient received four cycles of systemic chemotherapy, consisting of etoposide and cisplatin, with concurrent radiotherapy (6,000 cGy/30 fractions) to the mediastinal lesion and the metastatic brain lesion (4,200 cGy/12 fractions). A follow-up chest CT scan and brain MRI showed a decrease in the size of the left upper mediastinal mass and brain lesion. We report a rare case of the primary thymic adenocarcinoma with a literature review.