• Title/Summary/Keyword: Cerebral location

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Evaluation of Radiation Dose according to Aneurysm Size and Location during Cerebral Aneurysm Coil Embolization (뇌동맥류 코일 색전술 시술 시 동맥류 크기 및 위치에 따른 방사선량 평가)

  • An, Hyun
    • Journal of radiological science and technology
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    • v.45 no.5
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    • pp.407-412
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    • 2022
  • Cerebral aneurysm coil embolization has the advantages of accurate, low patient burden, and fast recovery time, but efforts are needed to reduce dose due to the burden of exposure radiation dose during interventional procedures. In this study, the area dose product(DAP/Gy·cm2) and fluoro time(min) according to the size of the aneurysm and the location of aneurysm were investigated according to insurance recognition regulations aneurysm classification cerebral aneurysm coil embolization. According to the research method, classification according to the size and location of the aneurysm is first, the size of the aneurysm is divided into less than 4mm, more than 4mm to less than 8mm, and more than 8mm, and second, the dose to the area based on the location site (DAP/Gy·cm2) and fluoro time(min) based on the location site were observed. As a result, the location of the cerebral aneurysm procedure was found to be the Paraclinoid site. During cerebral aneurysm coil embolization, the area dose was 107 Gy·cm2 and fluoro time was 47.41 minutes, showing lower results than domestic studies, and when comparing the area dose product with foreign studies, the area dose product results were similar to that of Turkey and Saudi Arabia. It is expected that it can be used as an objective analysis indicator to establish diagnostic reference levels (DRLs) and patient radiation defense guidelines according to the size of cerebral aneurysm and location of cerebral aneurysm procedures during interventional procedures.

Clinical Observation for Prognosis Utilizing Brain Computerized Tomography Findings and Barthel Index In Acute Cerebral Infarction (급성 뇌경색 환자의 Brain-CT 소견과 Barthel ADL을 이용한 예후에 관한 고찰)

  • Lee, Won-Chul
    • 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.

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Analysis of Patients with Cerebral Aneurysm Rupture Treated by Coil Embolization : Retrograde Study in Single Institute (코일색전술로 치료받은 뇌동맥류 파열 환자 분석 : 단일기관 후향적 연구)

  • Kim, Seung-Gi
    • Journal of radiological science and technology
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    • v.42 no.5
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    • pp.357-363
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    • 2019
  • To the basic information of patients with subarachnoid hemorrhage due to rupture of cerebral aneurysm treated with coil embolization, and to identify the general trend of treatment through classification according to hospitalization route, residence distribution, location and size of cerebral aneurysm, and procedure. A total of 164 patients with ruptured cerebral aneurysms treated with coil embolization were 54(32.9%) males and 110(67.1%) females. The sex and frequency of occurrence by age group were the most in 50s(31.3%), and among them, females were the most. The hospitalization route was the most common in 122(74.4%) people who were admitted to the emergency room through 119 evacuation, 79(48.2%) patients lived in where hospitals belong to the hospital. The season had 23(14%) in December, 18(11%) in January, 15(9.1%) in February, and the anterior circulation was 153(93%). The largest size was 5-7 mm found in 63(38.4%) patients. Patients underwent initial coil embolization for subarachnoid hemorrhage due to cerebral aneurysm rupture treated more patients than the incidence of the population. As a result of cerebral aneurysm rupture was seasonally affected, and winter occurs more frequently, female than male, age 50 is most common, and ruptured cerebral aneurysm is 5-7 mm in size.

Clinical Observation for the 120 Cases of CVA (뇌전산화단층촬영(CT)상 확진된 120예의 뇌졸중환자에 대한 임상적 고찰)

  • Bae, Sung-Han;Nam, Chang-Gyu
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.168-184
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    • 1998
  • Clinical Observation was made on 120 Cases of CVA that were confirmed through brain CT of Oriental Medical hospital of Se-Myung University from July in 1997 to June in 1998. 1. The CVA cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), and the greatest in number among them were the cases of cerebral infarction. 2. The most cases were 50 of age in all cases, in cerebral infarction were over 70 of age. There is no significant difference in the frequency of strokes between the male and female. the ratio was 1.07 : 1. 3. The frequency of strokes seems to have no relation to month and season. 4. The course of entering hospital, most patients visited this hospital directly(not through any other hospital) within 24hours. 5. The first attack was noted in 80.8%, the recurrance attack in 19.2% and the cerebral infarction had high recurrance ratio compared with cerebral hemorrhage. 6. The average duration of hospitalization was 25.2 days. 7. The most ordinary preceding disease was hypertension. 8. The common symptoms were motor disturbance and dysphasia. 9. The most frequent location of the lesion in cerebral infarction was parietal lobe, in cerebral hemorrhage was basal ganglia. 10. According to electrocardiography findings, abnormality was noted in cerebral infarction more than cerebral hemorrhage, subarachnoid hemorrhage. 11. The hypercholesterolemia and hypertriglyceridemia were found more frequently in cerebral infarction than cerebral hemorrhage, subarachnoid hemorrhage. 12. The average time to start physical theraphy was 7.76 days after admission. 13. The most common complications were pneumonia and bed sore.

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Size and Location of Ruptured Intracranial Aneurysms

  • Jeong, Young-Gyun;Jung, Yong-Tae;Kim, Moo-Seong;Eun, Choong-Ki;Jang, Sang-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.11-15
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    • 2009
  • Objective : The aim of study was to review our patient population to determine whether there is a critical aneurysm size at which the incidence of rupture increases and whether there is a correlation between aneurysm size and location. Methods : We reviewed charts and radiological findings (computed tomography (CT) scans, angiograms, CT angiography, magnetic resonance angiography) for all patients operated on for intracranial aneurysms in our hospital between September 2002 and May 2004. Of the 336 aneurysms that were reviewed, measurements were obtained from angiograms for 239 ruptured aneurysms by a neuroradiologist at the time of diagnosis in our hospital. Results : There were 115 male and 221 female patients assessed in this study. The locations of aneurysms were the middle cerebral artery (MCA, 61), anterior communicating artery (ACoA, 66), posterior communicating artery (PCoA, 52), the top of the basilar artery (15), internal carotid artery (ICA) including the cavernous portion (13), anterior choroidal artery (AChA, 7), A1 segment of the anterior cerebral artery (3), A2 segment of the anterior cerebral artery (11), posterior inferior cerebellar artery (PICA, 8), superior cerebellar artery (SCA, 2), P2 segment of the posterior cerebral artery (1), and the vertebral artery (2). The mean diameter of aneurysms was $5.47{\pm}2.536\;mm$ in anterior cerebral artery (ACA), $6.84{\pm}3.941\;mm$ in ICA, $7.09{\pm}3.652\;mm$ in MCA and $6.21{\pm}3.697\;mm$ in vertebrobasilar artery. The ACA aneurysms were smaller than the MCA aneurysms. Aneurysms less than 6 mm in diameter included 37 (60.65%) in patients with aneurysms in the MCA, 43 (65.15%) in patients with aneurysms in the ACoA and 29 (55.76%) in patients with aneurysms in the PCoA. Conclusion : Ruptured aneurysms in the ACA were smaller than those in the MCA. The most prevalent aneurysm size was 3-6 mm in the MCA (55.73%), 3-6 mm in the ACoA (57.57%) and 4-6 mm in the PCoA (42.30%). The more prevalent size of the aneurysm to treat may differ in accordance with the location of the aneurysm.

Multiple Aneurysms on the Same Bifurcation Site of the Middle Cerebral Artery

  • Back, Byung-Suck;Choi, Seung-Jin;Ji, Cheol;Ahn, Jae-Geun
    • Journal of Korean Neurosurgical Society
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    • v.41 no.4
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    • pp.258-260
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    • 2007
  • Multiple aneurysms at the same cerebral arterial branching site are rare, and have been mainly described in a few case reports in comparison with other intracranial multiple aneurysms. Most reported locations of the same artery where multiple aneurysms developed were internal carotid artery and anterior communicating artery. We experienced a very rare case of multiple aneurysms arising at the same bifurcation site of the middle cerebral artery. Only one case like this has been reported previously in the literature. We discussed the preoperative diagnosis and surgical management of such condition.

Meanings of Stereoview in Cerebral Angiogram (뇌혈관 조영술에서 입체촬영의 의의)

  • Cho, Soo-Ho;Chi, Yong-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.53-57
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    • 1985
  • Many pictures must be taken for the presumption of the stereorelation of the cerebral artery, which obtained with ordinary cerebral angiography. And it is very difficult to understand the stereoimage and required many experiences. But it is able to presume the stereorelationship in only brief eye's training without the aid of the stereoscope using the prism. For the stereoview, we need the paired angiograms obtained only straight and tilting the X-ray tube. In practice, with this stereoview in cerebral angiogram, we could know the directions of the aneurysmal neck and fundus with the stereorelationship of the cerebral artery and indeed helps us greatly in operation field. In addition, we might guess the location and stereorelationships of the feeding artery and draining vein in arteriovenous malformation and other vascular tumors and it was great aid in diagnosis and operation. Now we present the methods of the pictures for the stereoview in cerebral angiogram and the methods for eye's training.

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A New Tool to Predict Survival after Radiosurgery Alone for Newly Diagnosed Cerebral Metastases

  • Rades, Dirk;Huttenlocher, Stefan;Dziggel, Liesa;Blanck, Oliver;Hornung, Dagmar;Mai, Khoa Trong;Ngo, Trang Thuy;Pham, Thai Van;Schild, Steven
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2967-2970
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    • 2015
  • Many patients with few cerebral metastases receive radiosurgery alone. The goal of this study was to create a tool to estimate the survival of such patients. To identify characteristics associated with survival, nine variables including radiosurgery dose, age, gender, Eastern cooperative oncology group performance score (ECOG-PS), primary tumor type, number/size of cerebral metastases, location of cerebral metastases, extra-cerebral metastases and time between cancer diagnosis and radiosurgery were analyzed in 214 patients. On multivariate analysis, age (p=0.03), ECOG-PS (p=0.02) and extra-cerebral metastases (p<0.01) had significant impacts on survival. Scoring points for each patient were obtained from 12-month survival rates (in %) related to the significant variables divided by 10. Addition of the scoring points of the three variables resulted in a patient's total predictive score. Two groups were designed, A (10-14 points) and B (16-17 points). Twelve-month survival rates were 33% and 77%, respectively (p<0.001). Median survival times were 8 and 20 months, respectively. Because most patients of group A died from extra-cerebral disease and/or new cerebral lesions, early systemic treatment and additional WBI should be considered. As cause of death in group B was mostly new cerebral metastases, additional WBI appears even more important for this group.

Cerebral Infarction Mimicking Skeletal Metastases on Tc-99m MDP Bone Scintigraphy

  • Lim, Seok-Tae;Park, Soon-Ah;Sohn, Myung-Hee;Yim, Chang-Yeol
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.433-435
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    • 2000
  • A 6000-year-old male with carcinoma of the prostate and cerebral infarction underwent a Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bone scintigraphy (Fig. 1) showed multiple areas of increased uptake of Tc-99m MDP in the skull, spine, and ribs representing skeletal metastases. Two different patterns of uptake occurred in the skull region (Fig. 1A-C); one represents bony metastasis and the ether represents cerebral infarction. The shape, size, location, intensity, and border of the increased uptake differed between the two lesions. An oval-shaped pattern with smaller size, greater intensity and more sharply defined border in the frontal region was consistent with bony metastasis. A rectangular-shaped pattern with larger size, lesser intensity and relatively indistinct border in the temporo-parieto-occipital region was consistent with cerebral infarction. Increased uptake of bone-seeking radiotracers in cerebral infarction has been reported previously.$^{1-4)}$ A suggested mechanism by which bone-seeking radiotracers accumulate in the necrotizing cerebral tissue is an alteration of the blood-brain barrier induced during cerebral infarction, which results in entry of the radiotracers into the extracellular space of the brain.$^{4)}$ Brain CT (Fig. 2) performed 7 days before and one month after the bone scintigraphy revealed lesions on the right temporo-parieto-occipital region consistent with acute hemorrhagic and chronic cerebral infarction, respectively.

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Cerebral Hemorrhage in Patients on Maintenance Hemodialysis (혈액투석을 받고있는 환자에서 자발성 뇌출혈)

  • Park, Jae Suk;Moon, Jae Gon;Kim, Chang Hyun;Lee, Ho Kook;Hwang, Do Yun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.115-119
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    • 2001
  • Objective : The cause and clinical outcome of cerebral hemorrhage in patients on maintenance hemodialysis have been poorly studied in korea. The purpose of this paper is to clarify the clincal features and the outcome of cerebral hemorrhage in patients on maintenance hemodialysis. Method : We analyzed clincal features and the outcome of cerebral hemorrhage in 14 patients on maintenance hemodialysis. Hematomas were reviewed and evaluated for location, size, and intraventricular extension by the one of the authors without any prior informations. The axial slice of CT film that the hematoma was appeared in maximal dimension was chosen for evaluations. Result : Hypertension was found in 71.4%(10 cases) and motality rate was 78.5%(11 cases). Basal ganglia hemorrhage was found in 50%(7 cases), subcortex in 28.5%(4 cases), pons in 14.2%(2 cases). Size of hematoma in patients on maintenance hemodialysis was significantly larger than that of hypertensive cerebral hemorrhage patients(p=0.0061). The 4 cases of basal ganglia hemorrhage without intraventricular hemorrhage and subarachnoid hemorrhage were good mental state at the onset of stroke because of small mass effect relative to the size of hematoma. The duration of hemodialysis treatment prior to strokes ranged from 1 to 107 months. Strokes developed within 6 hours of the previous hemodialysis are 5 cases. Average serum albumin concentration was 3.4g/dl. The use of heparin is less responsible for the development of cerebral hemorrhage in patients on maintenance hemodialysis Conclusion : Cerebral hemorrhage in patients on maintenance hemodialysis is more severe in terms of hematoma size and clinical outcome. Therefore, the prevention and treatment of cerebral hemorrhage in patients on maintenance hemodialysis should be more aggressive.

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