• Title/Summary/Keyword: Cerebral stroke

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Outcomes of Mechanical Thrombectomy in Patients with Large Diffusion-Weighted Imaging Lesions

  • Cho, Yong-Hwan;Choi, Jae Hyung
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.22-29
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    • 2022
  • Objective : Despite many advancements in endovascular treatment, the benefits of mechanical thrombectomy (MT) in patients with large infarctions remain uncertain due to hemorrhagic complications. Therefore, we aimed to investigate the efficacy and safety of recanalization via MT within 6 hours after stroke in patients with large cerebral infarction volumes (>70 mL). Methods : We retrospectively reviewed the medical data of 30 patients with large lesions on initial diffusion-weighted imaging (>70 mL) who underwent MT at our institution within 6 hours after stroke onset. Baseline data, recanalization rate, and 3-month clinical outcomes were analyzed. Successful recanalization was defined as a modified treatment in cerebral ischemia score of 2b or 3. Results : The recanalization rate was 63.3%, and symptomatic intracerebral hemorrhage occurred in six patients (20%). The proportion of patients with modified Rankin Scale (mRS) scores of 0-3 was significantly higher in the recanalization group than in the non-recanalization group (47.4% vs. 9.1%, p=0.049). The mortality rate was higher in the non-recanalization group, this difference was not significant (15.8% vs. 36.4%, p=0.372). In the analysis of 3-month clinical outcomes, only successful recanalization was significantly associated with mRS scores of 0-3 (90% vs. 50%, p=0.049). The odds ratio of recanalization for favorable outcomes (mRS 0-3) was 9.00 (95% confidence interval, 0.95-84.90; p=0.055). Conclusion : Despite the risk of symptomatic intracerebral hemorrhage, successful recanalization via MT 6 hours after stroke may improve clinical outcomes in patients with large vessel occlusion.

High-Resolution Magnetic Resonance Imaging Findings of Reversible Cerebral Vasoconstriction Syndrome associated with Severe Anemia: A Case Report (중증 빈혈과 관련된 가역적 뇌혈관 수축 증후군의 고해상도 자기공명영상 소견: 증례 보고)

  • Yongsang Kim;Ra Gyoung Yoon;Ji Ye Lee;Jong-Moo Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.261-266
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    • 2021
  • Ischemic stroke is one of the manifestations of reversible cerebral vasoconstriction syndrome (RCVS). Many precipitants and associated disorders of RCVS have been suggested. However, few case reports have indicated an association between anemia and RCVS. Here, we report a case of a 66-year-old female with severe iron deficiency anemia (IDA), who presented with ischemic stroke and cerebral vasoconstriction, which gradually improved with conservative treatment. High-resolution vessel wall magnetic resonance imaging findings and reversibility suggested the possibility of RCVS. In patients with RCVS and ischemic stroke, IDA should be considered. Prompt management should be delivered to prevent disease progression and recurrence.

Hematologic Characteristics of Stroke Inpatients according to Sasang Constitution in One Korean Medicine Hospital (뇌졸중 환자의 체질별 혈액학적 특성 -1개 한방병원의 입원환자를 중심으로-)

  • Jeon, Soo-Hyung;Kim, Jong-Won;Ryu, Dong-Hoon;Kim, Kyu-Kon;Lee, Yong-Tae
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.1
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    • pp.14-22
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    • 2013
  • Objectives The purpose of this study is to know hematologic characteristics of patients with stroke in Sasang Constitutional Medicine which will be helpful for the prevention and treatment of stroke. Methods We collected data from 111 patients who received treatment as a stroke inpatient at one Korean medicine hospital in Busan, Korea. A Sasang Constitutional Medicine(SCM) specialist diagnosed their Sasang Constitutional types based on the four diagnosis standard of SCM and herbal medicine reaction. Results of hematologic tests were classified according to gender, age, stroke types and Sasang Constitutional types and analysed by SAS system. Results 1. Male's mean value of RBC count, Hemoglobin and Hematocrit was lower than normal range. 2. The mean value of hsCRP of above age 65 group was 3.19 times significantly higher than under age 65 group. 3. The mean value of platelet of cerebral hemorrhage group was significantly higher than cerebral infarction group. 4. The mean value of triglyceride of Taeeumin was significantly higher than Soyangin and Soeumin. Conclusions For the prevention of stroke, appropriate treatment of stress, trauma and infections is needed and male require a regular and balanced meals. Especially Taeeumin need to eat small meals to avoid excessive accumulation of energy.

Neuroprotective Effects of Antioxidatives of Constituents Isolated from Plants

  • Jin, Chang-Bae;Lee, Yong-Sup;Cho, Jung-Sook
    • Proceedings of the PSK Conference
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    • 2003.04a
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    • pp.67-68
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    • 2003
  • Cerebral ischemia, the most prevalent form of clinical stroke, is a medical problem of the first magnitude. Substantial efforts are being made to develop drugs which will protect the brain from the neurodegeneration that follows ischemic stroke. However, no medical treatment is currently approved for the treatment of stroke to reduce brain infarction or neurological disability beyond tissue plasminogen activator. (omitted)

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Galanin's implications for post-stroke improvement

  • Song, Juhyun;Kim, Oh Yoen
    • Anatomy and Cell Biology
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    • v.49 no.4
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    • pp.223-230
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    • 2016
  • Stroke leads to a variety of pathophysiological conditions such as ischemic infarct, cerebral inflammation, neuronal damage, cognitive decline, and depression. Many endeavors have been tried to find the therapeutic solutions to attenuate severe neuropathogenesis after stroke. Several studies have reported that a decrease in the neuropeptide regulator 'galanin' is associated with neuronal loss, learning and memory dysfunctions, and depression following a stroke. The present review summarized recent evidences on the function and the therapeutic potential of galanin in post-ischemic stroke to provide a further understanding of galanin's role. Hence, we suggest that galanin needs to be considered as a therapeutic factor in the alleviation of post-stroke pathologies.

Progressive Manifestations of Reversible Cerebral Vasoconstriction Syndrome Presenting with Subarachnoid Hemorrhage, Intracerebral Hemorrhage, and Cerebral Infarction

  • Choi, Kyu-Sun;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • v.56 no.5
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    • pp.419-422
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    • 2014
  • Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by sudden-onset headache with focal neurologic deficit and prolonged but reversible multifocal narrowing of the distal cerebral arteries. Stroke, either hemorrhagic or ischemic, is a relatively frequent presentation in RCVS, but progressive manifestations of subarachnoid hemorrhage, intracerebral hemorrhage, cerebral infarction in a patient is seldom described. We report a rare case of a 56-year-old woman with reversible cerebral vasoconstriction syndrome consecutively presenting as cortical subarachnoid hemorrhage, intracerebral hemorrhage, and cerebral infarction. When she complained of severe headache with subtle cortical subarachnoid hemorrhage, her angiography was non-specific. But, computed tomographic angiography showed typical angiographic features of this syndrome after four days. Day 12, she suffered mental deterioration and hemiplegia due to contralateral intracerebral hematoma, and she was surgically treated. For recurrent attacks of headache, medical management with calcium channel blockers has been instituted. Normalized angiographic features were documented after 8 weeks. Reversible cerebral vasoconstriction syndrome should be considered as differential diagnosis of non-aneurysmal subarachnoid hemorrhage, and repeated angiography is recommended for the diagnosis of this under-recognized syndrome.

The Effect on Activity of Cerebral Cortex by Key-point Control of The Adult Hemiplegia with fMRI (fMRI를 이용한 성인 편마비의 항조절점 운동이 대뇌피질의 활성화에 미치는 효과)

  • Lee Won-Kil
    • The Journal of Korean Physical Therapy
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    • v.15 no.3
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    • pp.295-345
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    • 2003
  • This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.

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Photochemically Induced Cerebral Ischemia in a Mouse Model

  • Park, Sung-Ku;Lee, Jung-Kil;Moon, Kyung-Sub;Joo, Sung-Pil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.180-185
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    • 2006
  • Objective : Middle cerebral artery occlusion[MCAO] has widely been used to produce ischemic brain lesions. The lesions induced by MCAO tend to be variable in size because of the variance in the collateral blood supply found in the mouse brain. To establish a less invasive and reproducible focal ischemia model in mice, we modified the technique used for rat photo thrombosis model. Methods : Male C57BL/6 mice were subjected to focal cerebral ischemia by photothrombosis of cortical microvessels. Cerebral infarction was produced by intraperitoneal injection of Rose Bengal, a photosensitive dye and by focal illumination through the skull. Motor impairment was assessed by the accelerating rotarod and staircase tests. The brain was perfusion-fixed for histological determination of infarct volume four weeks after stroke. Results : The lesion was located in the frontal and parietal cortex and the underlying white matter was partly affected. A relatively constant infarct volume was achieved one month after photothrombosis. The presence of the photothrombotic lesion was associated with severe impairment of the motor performance measured by the rotarod and staircase tests. Conclusion : Photothrombotic infarction in mice is highly reproducible in size and location. This procedure can provide a simple method to produce cerebral infarction in a unilateral motor cortex lesion. In addition, it can provide a suitable model for study of potential neuroprotective and therapeutic agents in human stroke.

Implementation of Non-Invasive Cerebral Perfusion Platform (비침습적 대뇌관류 장치의 구현)

  • Kwon, Seong-tae;Lee, Jean;Kim, Young-kil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.5
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    • pp.1016-1026
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    • 2017
  • Shipping Along with the aging of the total population, its importance is greater cause of stroke, which is one of the diseases are listed cerebral perfusion is about 80%,.ie that the flow of blood flowing to the brain is reduced as the cause. One of the most typical prophylaxis and treatment of these stroke is to enhance cerebral perfusion. There are several ways to increase cerebral blood flow are a therapy through drugs, through surgery and invasive NeuroFlo. NeuroFlo is to insert a catheter to which a balloon is attached into a patient's artery. However, since the method of enhancing conventional cerebral perfusion have been conducted mainly in invasive method, giving a burden to the patient, the problem of inducing a number of complications were noted. In this paper, an attempt to supplement the shortcomings of such invasive brain perfusion increase method, to provide a device to enhance the non-invasively brain perfusion.

Transient Middle Cerebral Artery Occlusion Model in Mouse using Nylon Thread (Nylon Thread를 이용한 mouse 에서의 Transient middle cerebral artery occlusion (MCAO) model 확립)

  • Lim, Byung-Chul;Sung, Ji-Hee;Kim, Ha-Na;Park, Seoung-Woo
    • The Journal of the Korea Contents Association
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    • v.19 no.7
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    • pp.186-191
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    • 2019
  • Introduction: In aged people, stroke incidence is increased. But standardized experimental animal protocol study for the research of stroke therapy is rare. There is little report on the success rate of cerebral artery occlusion model using standardized Nylon thread length of precise thread end-size controlled. Method: In this study, the operator intended the occlusion of middle cerebral artery (MCA) using $0.18{\pm}0.02mm$ end 5-0 Nylon thread. Middle cerebral artery occlusion was induced for 60min under isoflurane anesthesia. After 60min, the operator removed the Nylon thread and reperfusion was induced for 23hrs. The mice was killed 23hrs after reperfusion and infarction area of brain was confirmed by 1.5% TTC (2,3,5-tryphenyl tetrazolium chloride) staining. Results: According to end size and insert length of Nylon thread, Middle cerebral artery occlusion (n=50), internal carotid artery occlusion (n= 14), distal middle cerebral artery occlusion (n= 36), anterior cerebral artery (n= 1) were induced. And no infarction (n= 50) was observed. Conclusion: According to weight of mice, the operator induced reversible cerebral artery occlusion model by different insert length (30.0~36.9g : 9.0mm, 37.0~40.0g : 9.5mm) of Nylon thread. Success of cerebral artery occlusion model was confirmed by checking infarction area using TTC staining. The success rate (66.9%, 101/151) of reversible cerebral artery occlusion model in the mouse and the operational conditions are shown.