• Title/Summary/Keyword: Carotid

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Surgical Treatment of Intracranial Artery Giant Aneurysm Using Cardiopulmonary Bypass and Deep Hypothermic Circulatory Arrest - Case Report - (체외순환과 초저체온 순환정지술을 이용한 내경동맥의 거대 뇌동맥류 수술 - 증 례 보 고 -)

  • Chung, You Nam;Min, Kyung Soo;Lee, Mou Seop;Kim, Dong Ho;Hong, Jong Myeon;Kim, Sang Tai
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1657-1663
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    • 2000
  • The authors report a case of a 72-year-old woman who presented with intraventricular and subarachnoid hemorrhage of Hunt and Hess grade IV after the rupture of a giant aneurysm arising from the right internal carotid artery. The aneurysm was clipped successfully with the aid of cardiopulmonary bypass(closed chest method), deep hypothermic circulatory arrest, and cerebral protection with barbiturate resulting in moderate disability. We discuss the usefulness and problems related to technique of circulatory arrest and cardiopulmonary bypass using closed chest method, and suggest the possible benefits of open chest method in elderly people and the importance of preoperative plan to coordinate anesthesia and operation.

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Endovascular Treatment of Traumatic Arteriovenous Fistula in Young Adults with Pulsatile Tinnitus

  • Kim, Hyun Sik;Song, Joon Ho;Oh, Jae Keun;Ahn, Jun Hyong;Kim, Ji Hee;Chang, In Bok
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.532-538
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    • 2020
  • Traumatic arteriovenous fistulas (AVFs) involving the external carotid artery are exceedingly rare in young adults. Since an AVF is the most common life-threatening cause for pulsatile tinnitus (PT), meticulous evaluation and treatment of patients with PT is crucial. Here, we present two traumatic AVF cases treated with coil embolization leading to no residual fistulous connections followed by an immediate and complete resolution of PT. A 20-year-old man developed left ear tinnitus three months after a traumatic brain injury involving the right temporal bone fracture. Cerebral angiography demonstrated an enlarged left middle meningeal artery (MMA) and a fistular point at the posterior branch of the MMA draining to the middle meningeal vein (MMV) and the left pterygoid plexus, suggesting an AVF. Another 18-year-old girl developed left tinnitus, left exophthalmos, and conjunctival injection 6 months after a traffic accident involving no demonstrable abnormal findings in the radiologic exam. Magnetic resonance angiography demonstrated a markedly dilated left MMA draining to the MMV, left cavernous sinus, and left superior ophthalmic vein. In both cases, coil embolization was performed with total obliteration of the fistular point.

Effects of Hand Acupuncture Therapy on Sleep Quality in Sleep Disrupted Adults - Verification by Polysomnography and Cerebral Blood Flow Test - (수지요법이 수면장애를 가진 성인의 수면의 질에 미치는 효과 - 수면다원검사 및 뇌혈류 검사를 통한 검증 -)

  • Hwang, Eun-Hee
    • Journal of Korean Academy of Nursing
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    • v.37 no.7
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    • pp.1108-1118
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    • 2007
  • Purpose: The purpose of this study was to identify the effects of hand acupuncture therapy on sleep quality by means of a sleep questionnaire, polysomnography and a cerebral blood flow test in $30{\sim}59$ year old adults. Methods: The study was a sham controlled design. Twenty-two adults were assigned to the pellet stimulating group (11) or sham group (11). The pellet stimulating group received hand acupuncture therapy using New Seoam Press Pellets number 1 for 4 weeks. On the other hand, the sham group used the same Adhesive tape in terms of shape, size and quality as New Seoam Press Pellets number 1 for 4 weeks. A Transcranial Doppler Ultrasonography and Carotid Duplex Ultrasonography examination were used for evaluating cerebral blood flow. Data was analyzed using the SPSS 12.0 version program with $X^2-test$, Fisher's exact test and Mann Whitney U-test. Results: In the pellet stimulating group, subjective sleep quality significantly improved more than that of the sham group. Among the sleep indices of the polysomnography, total sleep time and sleep latency of the sham group significantly improved. The cerebral blood flow test didn't show any differences. Conclusion: These results suggest that hand acupuncture therapy is effective for subjective sleep improvement only, not polysomnographical sleep indices and cerebral blood flow.

Persistent Trigeminal Artery Detected by Conventional Angiography and Magnetic Resonance Angiography

  • Kim, Myoung-Soo;Hur, Jin-Woo;Lee, Jong-Won;Lee, Hyun-Koo
    • 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.

Serious Blood-Brain Barrier Disruption after Coil Embolization of Unruptured Intracranial Aneurysm : Report of Two Cases and Role of Immediate Postembolization CT Scan

  • Lee, Kyung-Kyu;Kang, Dong-Hun;Kim, Yong-Sun;Park, Jae-Chan
    • Journal of Korean Neurosurgical Society
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    • v.50 no.1
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    • pp.45-47
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    • 2011
  • Abnormal contrast enhancement on brain computed tomography (CT) scan after diagnostic or interventional angiography is not rare, and has known to be induced by temporary blood-brain barrier (BBB) disruption from contrast media. Furthermore, it has been regarded as clinically subtle, but reported to have no symptom or mild transient symptoms. However, we recently experienced two cases of serious BBB disruption during the acute period after coiling of an unruptured intracranial aneurysm. One patient presented with an unruptured paraclinoid internal carotid artery (ICA) aneurysm on the right and the other with an unruptured right supraclinoid ICA aneurysm. Both patients showed similar findings on immediate postembolization CT scan and clinical courses after coiling. Typical radiological, clinical characteristics of BBB disruption were described. In addition, the role of immediate postembolization CT scan are also discussed.

Spontaneous Intraorbital Hemorrhage : A Case Report

  • Kwon, Jae-Hyun;Song, Young-Jin;Choi, Sun-Seob;Kim, Ki-Uk
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.156-158
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    • 2008
  • Intraorbital hemorrhage is a rare clinical condition caused by orbital trauma, surgery around the orbit, intraorbital vascular abnormalities, and neoplasm. It was reported to occur spontaneously without any known causes and in association with orbital pseudotumor in a very few cases. A 59-year-old, female patient admitted with sudden onset of severe exophthalmos and pain on the left eye. Orbital CT and MR imaging suggested hemorrhage in the upper part of retrobulbar area of the left orbit. Cerebral angiography was taken to rule out any possible vascular abnormalities. On the left carotid cerebral angiography, the run-off of the distal ophthalmic artery was not seen and the engorgement of the supraophthalmic artery was noted. Systemic administration of corticosteroid did not improve the clinical status and craniectomy was done and retrobulbar hematoma was removed, and the clinical symptoms and signs were improved. Authors report a case of spontaneous intraorbital hemorrhage with the clinical features similar to those of orbital pseudotumor, requiring surgical decompression.

MR Spectroscopy of Cerebral Fat Embolism in Cats

  • Park Byung-Rae
    • Biomedical Science Letters
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    • v.11 no.2
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    • pp.221-225
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    • 2005
  • To investigate the spectroscopic findings of embolized lesions induced with a fat-emulsion technique with magnetic resonance images (MRI). A fat emulsion was made with 0.1 ml of triolein and 20 ml of normal saline. In 12 cats, the internal carotid artery was infused with the fat emulsion. Contrast-enhanced T1-weighted MRI and multivoxel spectroscopy were obtained at 1 hour, 1 and 4 days, and 1 week after embolization. NAA (N-acetylaspartate), Cr (creatine) and Cho (choline) were evaluated on the spectroscopy. Statitistical analysis wsperformed at the embolized and contralateral normal hemisphere in the integral and amplitude of NAA, Cr and Nho in time course. Also NAA/Cr and Cho/Cr were compared in both hemisphere and in time course. The emboli zed lesions showed contrast enhance ments on Gd-enhanced Tl-weighted i~ages at 1 hour. This contrast enhancement was decreased at day 1, and id not appear agter day 4. In spectroscopy, the embolized hemisphere showed no statistical difference to the normal contralateral side at 1 hour and in time course. NAA/Cr and Cho/Cr were not significantly different in both hemispheres at 1 hour and in time course. Cerebral-fat embolism induced by a triolein emulsion in cats revealed no statistical difference on MR spectroscopy. Triolein-emulsion can be used in the study of blood-brain barrier.

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The Effect of NEES on the Occurrence of Caspase-3 in the Cerebellum of Rats with Transient Global Ischemia

  • Lee, Jung Sook;Song, Young Wha;Kim, Sung Won
    • Journal of International Academy of Physical Therapy Research
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    • v.5 no.2
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    • pp.718-722
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    • 2014
  • The cerebellum is known to control balance, equilibrium, and muscle tone. If the cerebellum becomes damaged, the body is unable to retain its balancing functions or involuntary muscle movement. This is why, in stroke patients, there is a high risk of functional disability, as well as a myriad of other disabilities secondary to stroke. Ischemia was induced in SD mice by occluding the common carotid artery for 5 minutes, after which blood was reperfused. Needle electrode electrical stimulation(NEES) was applied to acupuncture points, at 12, 24, and 48 hours post-ischemia on the joksamri. Protein expression was investigated through caspase-3 antibody immuno-reactive cells in the cerebral nerve cells and Western blotting. The results were as follows: The number of caspase-3 reactive cells in the corpus cerebellum 12 and 24 hours post-ischemia was significantly (p<.05) smaller in the NEES group compared to the GI group. caspase-3 expression 12 and 24 hours post-ischemia was significantly(p<.05) smaller in the NEES group compared to the GI group. Based on these results, NEES seems to have a significant effect on Caspase-3 in the cerebellum in an ischemic state at 12 and 24 hours post ischemia, NEES delays the occurrence of early stage apoptosis-inducing Caspase-3, delaying and inhibiting apoptosis. Further systematic studies will have to be conducted in relation to the application of this study's results on stroke patients.

Pre-ischemic Treatment with Ampicillin Reduces Neuronal Damage in the Mouse Hippocampus and Neostriatum after Transient Forebrain Ischemia

  • Lee, Kyung-Eon;Kim, Seul-Ki;Cho, Kyung-Ok;Kim, Seong-Yun
    • The Korean Journal of Physiology and Pharmacology
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    • v.12 no.6
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    • pp.287-291
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    • 2008
  • Ampicillin, a $\beta$-lactam antibiotic, has been reported to induce astrocytic glutamate transporter-l which plays a crucial role in protecting neurons against glutamate excitotoxicity. We investigated the effect of ampicillin on neuronal damage in the mouse hippocampus and neostriatum following transient global forebrain ischemia. Male C57BL/6 mice were anesthetized with halothane and subjected to bilateral occlusion of the common carotid artery for 40 min. Ampicillin was administered post-ischemically (for 3 days) and/or pre-ischemically (for $3{\sim}5$ days until one day before the onset of ischemia). Pre- and post-ischemic treatment with ampicillin (50 mg/kg/day or 200 mg/kg/day) prevented ischemic neuronal death in the medial CAI area of the hippocampus as well as the neostriatum in a dose-dependent manner. In addition, ischemic neuronal damage was reduced by pre-ischemic treatment with ampicillin (200 mg/kg/day). In summary, our results suggest that ampicillin plays a functional role as a chemical preconditioning agent that protects hippocampal neurons from ischemic insult.

Renal Action of Idazoxan, ${\alpha}_2-Adrenergic$ Antagonist, in Dog (${\alpha}_2-Adrenergic$ Receptor 차단제인 Idazoxan의 신장작용)

  • 고석태;강경원
    • Biomolecules & Therapeutics
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    • v.8 no.2
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    • pp.132-139
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    • 2000
  • This study was performed far investigation of influence on renal function of idazoxan, $\alpha_{2}$-adrenergic antagonist, using the dog. Idazoxan, when giver. into vein, produced the decrease of urine volume(vol) accompanied with the reduction of free water clearance($C_{H2O}$), amounts of sodium excreted in urine($E_{Na}$), with the increase of potassium excreted in urine($E_{K}$), and so ratios of potassium against sodium($K^{+}/Na^{+}$) were elevated, at this time, greatened reabsorption rate of sodium and diministered that of potassium in renal tubules were appeared. Idazoxan administered into a renal artery elicited the augmentation of vol, glomerular filtration rate(GFR), renal plasma flow(RPF) and no change of filtration fraction(FF) in only ipsilateral kidney, whereas $E_{Na},\;E_{K}\;and\;K^{+}/Na^{+}$ were increased and $C_{H2O}$ was decreased in both control and experimental kidney. Idazoxan given into carotid artery showed partial increased vol, remarkable expanded RPF and unchanged GFR, and so filtration fraction(FF) was markedly reduced. Above results suggest that anti- diuretic action of idazoxan given into vein is mediated by reduction of $C_{H2O}\;and\;E_{Na}$, diuretic action only in the ipsilateral kidney by idazoxan given into a renal artery is caused by hemodynamic improvement through expansion of vas afferens in glomeruli.

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