• Journal of Preventive Medicine and Public Health
• /
• 제40권4호
• /
• pp.313-320
• /
• 2007

Objectives : To evaluate the association between body mass index (BMI) and hemorrhagic stroke. Methods : A case-control study was conducted on 2,712 persons (904 cases, 904 hospital controls, and 904 community controls) participating in an Acute Brain Bleeding Analysis study from October 2002 to March 2004. Two controls for each case were matched according to age and gender. The information was obtained by trained interviewers using standardized questionnaire. A conditional logistic regression model was used to estimate the association between BMI and the frequency of having a hemorrhagic stroke. Results : Obese men (25.0 $\leq$ BMI < $30.0\;kg/m^2$) had an odds ratios (OR) of 1.39 (95% CI 1.03 to 1.87) a hemorrhagic stroke, compared to men with a normal BMI (18.5 to $24.9\;kg/m^2$). Conversely, women with lower BMI had a higher risk of having hemorrhagic stroke. With respect to subtypes of hemorrahagic stroke, we observed about a three-fold increase in the risk of intracerebral hemorrhage (ICH) in the highly obese group. However, these trends were not significant in patients with subarachnoid hemorrhages. Conclusions : Obesity was identified as one of the risk factors in hemorrhagic stroke, in particular ICH. Conversely, in women, a lean body weight increases the risk of hemorrhagic stroke. Consequently, managing one's weight is essential to reduce the risks of hemorrhagic stroke.

• Journal of Korean Neurosurgical Society
• /
• 제60권5호
• /
• pp.604-609
• /
• 2017

Objective : An adjustable Ghajar guide is presented to improve the accuracy of the original Ghajar guide technique. The accuracy of the adjustable Ghajar guide technique is also investigated. Methods : The coronal adjustment angle from the orthogonal catheter trajectory at Kocher's point is determined based on coronal head images using an electronic picture archiving and communication system. For the adjustable Ghajar guide, a protractor is mounted on a C-shaped basal plate that is placed in contact with the margin of a burrhole, keeping the central $0^{\circ}$ line of the protractor orthogonal to the calvarial surface. A catheter guide, which is moved along the protractor and fixed at the pre-determined adjustment angle, is then used to guide the ventricular catheter into the frontal horn adjacent to the foramen of Monro. The adjustable Ghajar guide technique was applied to 20 patients, while a freehand technique based on the surface anatomy of the head was applied to another 47 patients. The accuracy of the ventricular catheter placement was then evaluated using postoperative computed tomography scans. Results : For the adjustable Ghajar guide technique (AGT) patients, the bicaudate index ranged from 0.23 to 0.33 ($mean{\pm}standard$ deviation [SD] : $0.27{\pm}0.03$) and the adjustment angle ranged from $0^{\circ}$ to $10^{\circ}$ ($mean{\pm}SD:5.2^{\circ}{\pm}3.2^{\circ}$). All the AGT patients experienced successful cerebrospinal fluid diversion with only one pass of the catheter. Optimal placement of the ventricular catheter in the ipsilateral frontal horn approximating the foramen of Monro (grade 1) was achieved in 19 patients (95.0%), while a suboptimal trajectory into a lateral corner of the frontal horn passing along a lateral wall of the frontal horn (grade 3) occurred in 1 patient (5.0%). Thus, the AGT patients experienced a significantly higher incidence of optimal catheter placement than the freehand catheterized patients (95.0% vs. 68.3%, p=0.024). Moreover, none of the AGT patients experienced any tract hemorrhages along the catheter or procedure-related complications. Conclusion : The proposed adjustable Ghajar guide technique, using angular adjustment in the coronal plane from the orthogonal trajectory at Kocher's point, facilitates accurate freehand placement of a ventricular catheter for hydrocephalic patients.