• 대한의용생체공학회:의공학회지
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• 제24권2호
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• pp.61-68
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• 2003

본 논문에서는 의학적 진단 및 처치 방법의 결정에 중요한 역할을 하는 뇌경색 환자의 각 시기별 특징을 정량화하기 위해 3 가지 MRI 촬영기법을 이용하여 획득한 영상의 특징과 그들의 상관관계들을 객체중심 계층적계획기법을 이용하여 분석하였다. 3 가지 영상의 비교를 위하여 다항워핑 알고리즘과 어파인 변환기법을 수행하여 영상을 정합하였으며, 정합된 영상을 기반으로 뇌경색 시기별 정량화를 수행하였다. 그리고 각 시기별로 색을 설정하여 수 작업으로 얻어진 데이터를 바탕으로 의사 컬러로 나타내었다. 본 연구에서 구한 뇌경색 시기별 정량화 자료를 바탕으로 구분된 결과와 전문의가 판단한 결과를 비교하였다.

• 한국정밀공학회지
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• 제23권1호
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• pp.209-215
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• 2006

The present study purposed to examine differences between 20s and 40s in visuospatial performance, the number of activated yokels and cerebral lateralization using functional Magnetic Resonance Imaging (fMRI). For this study, eight college students in their twenties (21.5 years on the average) and six adults in their forties (45.7 years on the average) participated in the experiment. Functional brain images were taken from 37 MRI using the single-shot EPI method. Compared to the twenties the forties showed lower visuospatial performance and longer reaction time. In addition, compared to the twenties the forties had a smaller number of activated yokels and less cerebral lateralization. The results of this study show that people's visuospatial performance and number of activated yokels decrease with aging. In addition, they also suggest that cerebral lateralization decreases in order to supplement the lowering of visuospatial performance, which in turn symmetrizes the activation of the left and right hemisphere.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.420-422
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• 2012

Cerebral aspergillosis is rare and usually misdiagnosed because its presentation is similar to that of a tumor. The correct diagnosis is usually made intra-operatively. Cerebral abscess with fungal infection is extremely rare and few cases have been reported, but it carries a poor prognosis. A 73 year-old man presented with decreased visual acuity and paresis of the right cranial nerve III. Magnetic resonance imaging (MRI) revealed a mass in the right cavernous sinus, extened to the anterior crainial fossa and the superior orbital fissure. During surgery, a well encapsulated pus pocket was found, and histopathological examination of the mass resulted in the diagnosis of aspergillosis. Despite appropriate anti-fungal treatment, the patient eventually died from fatal cerebral ischemic change and severe brain swelling. The correct diagnosis of cerebral aspergillosis can only be achieved by histopathological examination because clinical and radiological findings including MRI are not specific. Surgical intervention and antifungal therapy should be considered the optimal treatment. Early diagnosis and aggressive antifungal treatment provide good results.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.159-162
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• 2008

Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondary to severe carotid stenosis. Stenting was performed for treatment of the right carotid artery stenosis after a one-week cerebral angiogram was completed. Thirty minutes after stent placement, the patient exhibited a generalized seizure. Four hours later, brain MRI revealed left hemispheric cerebral infarction. Complex aorta-like arch elongation, tortuosity, calcification, and acute angulation at the origin of the supra-aortic arteries may increase the risk of procedural complications. In our case, we suggest that difficult carotid artery catheterization, with aggressive maneuvering during stenting, likely injured the tortuous, atherosclerotic aortic arch, and led to infarction of the contralateral cerebral hemisphere by thromboemboli formed on the wall of the atherosclerotic aorta.

• Journal of Genetic Medicine
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• 제18권2호
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• pp.105-109
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• 2021

Tetrasomy 18p is a genetic syndrome caused by an isochromosome consisting of two copies of the short arm of chromosome 18. Clinically, pediatric cases of tetrasomy 18p manifest with global developmental delay, similar to most cases of chromosomal abnormality. In addition, it causes various symptoms including abnormal muscle tone. We report a case of an infant with global developmental delay and remarkable spasticity, the typical phenotype of bilateral spastic cerebral palsy. However, she had a subtle anomaly in her face, and brain magnetic resonance imaging (MRI) findings were inconsistent with her strong upper motor neuron signs. Upon genetic testing, she was determined to have an 18p isochromosome, confirming de novo non-mosaic tetrasomy 18p. Cerebral palsy is a neurological disorder that includes developmental delay caused by a non-progressive lesion in the developing brain. During diagnostic workup in patients with cerebral palsy, genetic testing should be considered when there are minor physical anomalies or equivocal MRI findings.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.346-351
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• 2016

Objective : Early progressive infarction (EPI) is frequently observed and related to poor functional outcome in patients with middle cerebral artery (MCA) infarction caused by MCA occlusion. We evaluated the perfusion parameters of magnetic resonance imaging (MRI) as a predictor of EPI. Methods : We retrospectively analyzed patients with acute MCA territory infarction caused by MCA occlusion. EPI was defined as a National Institutes of Health Stroke Scale increment ${\geq}2$ points during 24 hours despite receiving standard treatment. Regional parameter ratios, such as cerebral blood flow and volume (rCBV) ratio (ipsilateral value/contralateral value) on perfusion MRI were analyzed to investigate the association with EPI. Results : Sixty-four patients were enrolled in total. EPI was present in 18 (28%) subjects and all EPI occurred within 3 days after hospitalization. Diabetes mellitus, rCBV ratio and regional time to peak (rTTP) ratio showed statically significant differences in both groups. Multi-variate analysis indicated that history of diabetes mellitus [odds ratio (OR), 6.13; 95% confidence interval (CI), 1.55-24.24] and a low rCBV ratio (rCBV, <0.85; OR, 6.57; 95% CI, 1.4-30.27) was significantly correlated with EPI. Conclusion : The incidence of EPI is considerable in patients with acute MCA territory infarction caused by MCA occlusion. We suggest that rCBV ratio is a useful neuro-imaging parameter to predict EPI.

• Journal of Korean Neurosurgical Society
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• 제37권3호
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• pp.207-212
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• 2005

Objective: Classically, single photon emission tomography is known to be the reference standard for evaluating the hemodynamic status of patients with moyamoya disease. Recently, T2-weighted perfusion magnetic resonance(MR) imaging has been found to be effective in estimating cerebral hemodynamics in moyamoya disease. We aim to assess the utility of perfusion-weighted MR imaging for evaluating hemodynamic status of moyamoya disease. Methods: The subjects were fourteen moyamoya patients(mean age: 7.21 yrs) who were admitted at our hospital between Sep. 2001 to Sep 2003. Four normal children were used for control group. Perfusion MR imaging was performed before any treatment by using a T2-weighted contrast material-enhanced technique. Relative cerebral blood volume(rCBV) and time to peak enhancement(TTP) maps were calculated. Relative ratios of rCBV and TTP in the anterior cerebral artery(ACA), middle cerebral artery(MCA) and basal ganglia were measured and compared with those of the posterior cerebral artery(PCA) in each cerebral hemispheres. Using this data, we analysed the hemodynamic aspect of pediatric moyamoya disease patients in regarding to the age, Suzuki stage, signal change in FLAIR MR imaging, and hemispheres inducing symptoms. Results: The mean rCBV ratio of ACA, MCA did not differ between normal children and moyamoya patients. However the significant TTP delay was observed at ACA, MCA territories (mean = 2.3071 sec, 1.2089 see, respectively, p < 0.0001). As the Suzuki stage of patients is advanced, rCBV ratio is decreased and TTP differences increased. Conclusion: Perfusion MR can be applied for evaluating preoperative cerebral hemodynamic status of moyamoya patients. Furthermore, perfusion MR imaging can be used for determine which hemisphere should be treated, first.

• 대한영상의학회지
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• 제83권1호
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• pp.178-183
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• 2022

진성적혈구증가증은 드문 골수 증식성 질환이며 제어되지 않은 적혈구 생산으로 인해 절대 적혈구 질량이 증가한다. 진성적혈구증가증은 큰 혈관의 협착 또는 폐색과 함께 허혈성 뇌졸중의 위험이 높다. 진성적혈구증가증 환자에서 뇌경색에 대한 많은 증례 보고가 있다. 그러나 합병증으로 뇌졸중이 발생한 진성적혈구증가증 환자의 좁아진 혈관에서 혈관벽 자기공명영상 소견은 보고되지 않았다. 저자들은 뇌졸중으로 인해 입원한 후 PV로 진단된 30세 남성의 경동맥 VW-MRI 소견에 관해 보고하고자 하며, 이는 우리가 아는 한 영어로 된 첫 번째 보고이다.

• Journal of Yeungnam Medical Science
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• 제14권1호
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• pp.237-244
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• 1997

A 14-year old boy was admitted with stuporous mentality. CT scan, MRI and cerebral angiogram revealed SAH and a giant aneurysm of right middle cerebral artery($4{\times}5{\times}5.3cm$). To minimize surgical risk, endovascular treatment was done with MDS(mechanical detachable system)-spiral coil. Follow up MRI showed intraluminal thrombus formation of the aneurysm.

• Neonatal Medicine
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• 제25권2호
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• pp.85-89
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• 2018

Rotavirus is the major cause of gastroenteritis in children under the age of 5. Rotavirus infection may lead to several neurological complications as meningitis, encephalitis, convulsion, encephalopathy, hemorrhagic shock, central pontine myelinolysis, Guillain-Barre syndrome, and Reye's syndrome. Further, some reports have described diffuse cerebral white matter lesions on diffusion-weighted magnetic resonance imaging (MRI) in neonates with rotavirus induced seizures. Here, we report on three neonates with rotavirus induced seizures with cerebral white matter abnormalities on MRI.