• Title/Summary/Keyword: Brain stem infarction

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An autopsy case of cerebral arterial thrombosis after vaccination with ChAdOx1 nCOV-19

  • Hyeji Yang;Jaeyoon Ha;Hyun Wook Kang
    • Journal of Medicine and Life Science
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    • v.19 no.2
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    • pp.74-77
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    • 2022
  • We present a fatal case of cerebral arterial thrombosis after corona virus disease 19 (COVID-19) vaccination with ChAdOx1 nCOV-19. The deceased was a 63-year-old woman with no relevant medical history. She presented symptoms of nausea, fatigue, and headache immediately after vaccination. Ten days after vaccination, she suddenly started vomiting and developed high blood pressure. The patient eventually died 23 days after vaccination. Autopsy findings showed that the cerebral arteries and internal carotid arteries were fully enlarged and were compacted with thrombi. The brain stem showed ischemic necrosis, and extravasation from this necrotic lesion led to focal subarachnoid hemorrhage around the brain stem where large blood clots still remained. No aneurysms or atherosclerotic changes were found in these arteries. We note the following three facts. Firstly, all symptoms occurred immediately after vaccination; secondly, the main cause of death was consistent with known side effects of the vaccine; and lastly, the mechanism of thrombus formation in this case goes beyond the general category of thrombogenesis known so far. While the authors know that this case does not fall into known categories of vaccine side effects, we presenting this case to demonstrate that a comprehensive review of various possibilities related to vaccine side effects is needed to establish a COVID-19 defense system.

Case of Oriental Medicine Therapy on Intractable Hiccup Induced by Pontine Infarction (뇌교경색 발병후 병발된 난치성 애역의 치험 1례)

  • Kang, Baek-Gyu;Lee, Sun-Woo;Park, Sang-ParkMoo;Han, Deok-Jin;Lee, Jung-Wook;Kim, Hye-Jung;Moon, Byung-Soon;Lee, In
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.1
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    • pp.222-225
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    • 2008
  • Hiccup is one of common symptoms that remains poorly understood. The hiccups coordinating center is located in the brain-stem reticular formation. Hiccups may be derived from 400 medical origins. Stroke is an infrequent cause of intractable hiccups. Intractable hiccups in pontine infarction remain poorly understood. As for treatments of hiccups, physical stimulating methods, pharmacological therapies and surgery are occidental conventional methods. In Pharmacological therapies, antidepressants, gastric motility stimulants, antispastic drugs are commonly used. Oriental medicines and acupuncture are also used frequently to treat hiccups. We have treated a case of intractable hiccup induced by pontine infarction with herbal medication; Gwakhyangjeonggi-san gami, acupuncture and moxibustion, and successfully improved. This case showed oriental medicine therapy is effective in intractable hiccup induced by pontine infarction.

Waffle-Cone Technique Using Solitaire AB Stent

  • Park, Hye-Ran;Yoon, Seok-Mann;Shim, Jai-Joon;Kim, Sung-Ho
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.222-226
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    • 2012
  • The waffle-cone technique is a modified stent application technique, which involves protrusion of the distal portion of a stent into an aneurysm fundus to provide neck support for subsequent coiling. The authors report two cases of wide necked basilar bifurcation aneurysms, which were not amenable to stent assisted coiling, that were treated using the waffle-cone technique with a Solitaire AB stent. A 58-year-old woman presented with severe headache. Brain CT showed subarachnoid hemorrhage and angiography demonstrated a ruptured giant basilar bifurcation aneurysm with broad neck, which was treated with a Solitaire AB stent and coils using the waffle-cone technique. The second case involved an 81-year-old man, who presented with dizziness caused by brain stem infarction. Angiography also demonstrated a large basilar bifurcation unruptured aneurysm with broad neck. Solitaire AB stent deployment using the waffle-cone technique, followed by coiling resulted in near complete obliteration of aneurysm. The waffle-cone technique with a Solitaire AB stent can be a useful alternative to conventional stent application when it is difficult to catheterize bilateral posterior cerebral arteries in patients with a wide-necked basilar bifurcation aneurysm.

A Clinical Report of Wallenberg's Syndrome (청심연자탕을 복용한 후 호전된 Wallenberg's syndrome 환자 1례)

  • Shim, So-ra;Choi, Woo-jung
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.62-67
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    • 2009
  • Wallenberg's syndrome is a neurological condition caused by a stroke in the vertebral or posterior inferior cerebellar artery of the brain stem. Wallenberg's syndrome is also called Lateral Medullary Syndrome. In this case report, we are going to describe the clinical menifestation and progress of one case of Wallenberg's syndrome and review previously published case reports about it and compare them to our case. In conclusion, significant improvements were observed in some symptoms but there were some symptoms not improved such as paresthesia. So further researches are needed for more effective treatment.

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Two Attenuated Cases of Methicillin-Resistant Staphylococcus aureus Infection Treated by Oriental Internal Medicine (한방처치를 통한 Methicillin내성 포도구균 감염의 음성화 및 약독화 2례)

  • Ko, Chang-Nam;Yun, Sung-Woo;Park, Sung-Wook;Lee, Hyung-Chel;Lee, Sang-Wook
    • The Journal of Internal Korean Medicine
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    • v.23 no.2
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    • pp.298-305
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    • 2002
  • These cases were performed on the bases of clinical consideration about patients who had Methicillin-Resistant Staphylococcus aureus(MRSA) infection. One patient was a 67-years-old women who had sequela of inter cranial hemorrhage & inter ventricular hemorrhage, hypertention, urinary tract infection and pneumonia. Clinical symptoms were intermittent fever, sputum, Lt. side hemiparesis and dysphagia. She was chronic, repeated infection state. It could be regarded as "unpreparedness of the spirit which animates and controls the universe; 正氣虛", the oriental term which indicates a condition of chronic disease or general weakness. According to the oriental medicine principle, oriental medicine was taken such as Wunggunza-tang(六君子湯) and the patient had taken a turn for the better. After 3 months, MRSA infection diappeared. The other patient was a 43-years-old women who had Both brain stem infarction, Lt. cerebellar infarction, hypercholesterolemia, urinary tract infection and pneumonia, Clinical symptoms were quadriplegia, dysphagia(levin tube insert state), aphasia, respiration disorder(tracheostomy cannular keep state) and sputum. She was chronic, repeated infection state. It could be regarded as "unpreparedness of spleen energy, unpreparedness of both energy and blood; 脾氣虛, 氣血兩虛", the oriental term which indicates a condition of chronic disease or immunodeficiency. According to the oriental medicine principle, oriental medicine was taken such as Bojungyggi-tang(補中益氣湯), Palmul-tang(八物湯) and the patient had taken a turn for the better. After I month, MRSA was turned into Escherichia coli.

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Slowly Recovering Isolated Bilateral Abducens Nerve Palsy after Embolization of Ruptured Anterior Communicating Artery Aneurysm

  • Jeon, Jin Sue;Lee, Sang Hyung;Son, Young-Je;Chung, Young Seob
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.112-114
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    • 2013
  • Bilateral abducens nerve palsy related to ruptured aneurysm of the anterior communicating artery (ACoA) has only been reported in four patients. Three cases were treated by surgical clipping. No report has described the clinical course of the isolated bilateral abducens nerve palsy following ruptured ACoA aneurysm obliterated with coil. A 32-year-old man was transferred to our institution after three days of diplopia, dizziness and headache after the onset of a 5-minute generalized tonic-clonic seizure. Computed tomographic angiography revealed an aneurysm of the ACoA. Magnetic resonance imaging showed focal intraventricular hemorrhage without brain stem abnormalities including infarction or space-occupying lesion. Endovascular coil embolization was conducted to obliterate an aneurysmal sac followed by lumbar cerebrospinal fluid (CSF) drainage. Bilateral paresis of abducens nerve completely recovered 9 weeks after ictus. In conclusion, isolated bilateral abducens nerve palsy associated with ruptured ACoA aneurysm may be resolved successfully by coil embolization and lumbar CSF drainage without directly relieving cerebrospinal fluid pressure by opening Lillequist's membrane and prepontine cistern.

Treatment of Wallenberg's Syndrome Following Selective Nerve Root Block: A Case Report (요추부 선택적 신경근 차단술 이후 발생한 Wallenberg's Syndrome의 한방복합치료 1례)

  • Park, Seo-Hyun;Kwon, Jeong-Gook;Park, Jae-Won;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.4
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    • pp.107-115
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    • 2016
  • The occurrence of brain stem stroke after lumbar selective nerve root block seem to be an uncommon event comparing it to after cervical selective nerve root block. We recently experienced a 60-year-old man who were diagnosed as left lateral medullary infarction (Wallenberg's syndrome) after lumbar selective nerve root block. He was treated by traditional Korean medicine with acupunture, Pulsed electromagetic therapy (PEMT), herb medicine. The range of motion of upper and lower extremity, manual muscle test, Korean version of Berg balance scale (K-BBS) and Korean version of Barthel index (K-MBI) were adopted to measure the resulting recovery after 4 weeks treatment. Traditional Korean medicine was effective for rehabilitation of patient. Further studies are needed to set up and Korean medical protocol for Wallenberg's syndrome.

MicroRNAs in Human Diseases: From Cancer to Cardiovascular Disease

  • Ha, Tai-You
    • IMMUNE NETWORK
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    • v.11 no.3
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    • pp.135-154
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    • 2011
  • The great discovery of microRNAs (miRNAs) has revolutionized current cell biology and medical science. miRNAs are small conserved non-coding RNA molecules that post-transcriptionally regulate gene expression by targeting the 3' untranslated region of specific messenger RNAs for degradation or translational repression. New members of the miRNA family are being discovered on a daily basis and emerging evidence has demonstrated that miRNAs play a major role in a wide range of developmental process including cell proliferation, cell cycle, cell differentiation, metabolism, apoptosis, developmental timing, neuronal cell fate, neuronal gene expression, brain morphogenesis, muscle differentiation and stem cell division. Moreover, a large number of studies have reported links between alterations of miRNA homeostasis and pathological conditions such as cancer, psychiatric and neurological diseases, cardiovascular disease, and autoimmune disease. Interestingly, in addition, miRNA deficiencies or excesses have been correlated with a number of clinically important diseases ranging from cancer to myocardial infarction. miRNAs can repress the gene translation of hundreds of their targets and are therefore well-positioned to target a multitude of cellular mechanisms. As a consequence of extensive participation in normal functions, it is quite logical to ask the question if abnormalities in miRNAs should have importance in human diseases. Great discoveries and rapid progress in the past few years on miRNAs provide the hope that miRNAs will in the near future have a great potential in the diagnosis and treatment of many diseases. Currently, an explosive literature has focussed on the role of miRNA in human cancer and cardiovascular disease. In this review, I briefly summarize the explosive current studies about involvement of miRNA in various human cancers and cardiovascular disease.

Ultrasound-guided Intervention in Cervical Spine (경추부 초음파 유도하 중재술)

  • Moon, Sang Ho
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.49-66
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    • 2014
  • Traditionally, cervical interventions have been performed under fluoroscopy. But radiation exposure is the major concern when obtaining fluoroscopic images and even under real-time fluoroscopy with contrast media or CT guidance, some cases of serious spinal cord injuries, cerebellar and brain stem infarction have been reported by unintentional intra-arterial injections especially during the transforaminal root blocks. Recently, the use of ultrasound-guided cervical interventions have increased. Ultrasound offers visualization of soft tissues including major neurovascular structures and also allows to observe the spread of injectant materials around the target structure. Ultrasound is radiation free, easy to use and the image can be performed continuously while the injectant is visualized in real-time, increasing the precision of injection. Importantly, ultrasound allows visualization of major nerves and vessels and thus leads to improve safety of cervical interventions by decreasing the incidence of injury or injection into nearby vasculature. We therefore reviewed to investigate the feasibility of performing cervical interventions under real-time ultrasound guidance.

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