• Journal of Korean Physical Therapy Science
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• v.2 no.3
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• pp.645-651
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• 1995

The purpose of study was that the functional gains achieved by stroke patients after rehabilitation in the acute phase have been documented. Sixty stroke inpatients who were at least 3.57 month postonset participated;32 males and 28 females;mean age, 57.4 years. By the classification of diagnosis, 20 subjects were cerebral infarction and 27 subjects were cerebral hemorrhage. Activities of daily living(ADL) performance was investigated using the Klein-Bell ADL Scale. ADL test was practiced within physical therapy room. The outcome variables were first analyzed using frequency statistics. The functional gains of the patients with sex and hemiplegic site were then using an ANOVA. Mean score of dressing, elimination, mobility, bathing/hygiene, eating, and telephone use, 26.6, 56.0, 41.4, 36.5, 82.0, and 56.7. Mean score of total, 43.0. There was no significant difference in sex and hemiplegic site.

• Journal of Korean Neurosurgical Society
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• v.49 no.2
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• pp.92-96
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• 2011

Objective : We retrospectively evaluated the prognostic factors that can influence long-term survival in patients who suffered acute large cerebral infarction. Methods : Between June 2003 and October 2008, a total of 178 patients were diagnosed with a large cerebral infarction, and, among them, 122 patients were alive one month after the onset of stroke. We investigated the multiple factors that might have influenced the life expectancies of these 122 patients. Results : The mean age of the patients was $70{\pm}13.4$ years and the mean survival was $41.7{\pm}2.8$ months. The mean survival of the poor functional outcome group ($mRS{\geq}4$) was $33.9{\pm}3.3$ months, whereas that of the good functional outcome group ($mRS{\leq}3$) was $58.6{\pm}2.6$ months (p value=0.000). The mean survival of the older patients (270 years) was $29.7{\pm}3.4$ months, whereas that of the younger patients (<70 years) was much better as $58.9{\pm}3.2$ months (p value=0.000). Involvement of ACA or PCA territory in MCA infarction is also a poor prognostic factor (p value=0.021). But, other factors that are also known as significant predictors of poor survival (male gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous history of stroke, smoking, and dyslipidemia) did not significantly influence the mean survival time in the current study. Conclusion : Age (older versus younger than 70 years old) and functional outcome at one month could be critical prognostic factors for survival after acute large cerebral infarction. Involvement of ACA or PCA territory is also an important poor prognostic factor in patients with MCA territorial infarction.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.173-178
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• 2011

Objective : The rat middle cerebral artery thread-occlusion model has been widely used to investigate the pathophysiological mechanisms of stroke and to develop therapeutic treatment. This study was conducted to analyze energy metabolism, apoptotic signal pathways, and genetic changes in the hippocampus of the ischemic rat brain. Methods : Focal transient cerebral ischemia was induced by obstructing the middle cerebral artery for two hours. After 24 hours, the induction of ischemia was confirmed by the measurement of infarct size using 2,3,5-triphenyltetrazolium chloride staining. A cDNA microarray assay was performed after isolating the hippocampus, and was used to examine changes in genetic expression patterns. Results : According to the cDNA microarray analysis, a total of 1,882 and 2,237 genes showed more than a 2-fold increase and more than a 2-fold decrease, respectively. When the genes were classified according to signal pathways, genes related with oxidative phosphorylation were found most frequently. There are several apoptotic genes that are known to be expressed during ischemic brain damage, including Akt2 and Tnfrsf1a. In this study, the expression of these genes was observed to increase by more than 2-fold. As energy metabolism related genes grew, ischemic brain damage was affected, and the expression of important genes related to apoptosis was increased/decreased.Conclusion : Our analysis revealed a significant change in the expression of energy metabolism related genes (Atp6v0d1, Atp5g2, etc.) in the hippocampus of the ischemic rat brain. Based on this data, we feel these genes have the potential to be target genes used for the development of therapeutic agents for ischemic stroke.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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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.

• The Korean Journal of Pharmacology
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• v.29 no.1
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• pp.1-8
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• 1993

To elucidate involvement of platelet-activating factor (PAF) in cerebral ischemia-reperfusion injury, male Sprague-Dawley rats and albino mice of either sex were subjected to a 10-min bilateral carotid artery occlusion and 6-hr recirculation. The McGraw stroke index in mice was markedly inhibited by PAF antagonists, BN 52021 and CV 6209 (1 mg/kg, i.p., each) When they were administered 10 min before bilateral carotid artery occlusion or 1 hr after reperfusion. The increases in brain water content were significantly attenuated by treatment with BN 52021 or CV 6209 in both animals. BN 52021 exhibited a significant improvement in the postischemic blood pressure change in association with a beneficial effect on the delayed dilatation of pial arterioles after 10 min of ischemia. Thus it is suggested that PAF plays an important role as an endogenous mediator in development of cerebral ischemia-reperfusion injury, and further, specific antagonists to PAF will be able to prevent or reverse the pathological sequelae of cerebral ischemia.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.21 no.9
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• pp.1752-1760
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• 2017

One of the treatments and preventions of strokes such as ischemic stroke is to increase cerebral blood flow. This aims to minimize the size of the stroke by increasing the quantity of blood to the cerebral region circuitously. Several ways to increase cerebral blood flow are a therapy though drugs and through surgery. However these invasive method giving a burden to the patient, the problem of inducing a number of complications were noted. In this thesis, we propose a non-invasive brain flow enhancer to complement the disadvantages of such invasive treatment methods. To compensate for the shortcomings of the existing devices, the patient's blood pressure is accurately measured and the blood pressure is applied to the extremities, thereby increasing blood flow to the femoral region to produce blood clotting treatments. Although somewhat inadequate blood flow increases compared to conventional devices, blood flow can be significantly increased, which can be selectively.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.652-664
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• 2022

The Kernohan-Woltman notch phenomenon (KWNP) refers to an intracranial lesion causing massive side-to-side mass effect which leads to compression of the contralateral cerebral peduncle against the free edge of the cerebellar tentorium. Diagnosis is based on "paradoxical" motor deficit ipsilateral to the lesion associated with radiologic evidence of damage to the contralateral cerebral peduncle. To date, there is scarce evidence regarding KWNP associated neuroimaging patterns and motor function prognostic factors. A systematic review was conducted on Medline database from inception to July 2021 looking for English-language articles concerning KWNP, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research yielded 45 articles for a total of 51 patients. The mean age was 40.7 years-old and the male/female sex ratio was 2/1. 63% of the patients (32/51) suffered from head trauma with a majority of acute subdural hematomas (57%, 29/51). 57% (29/51) of the patients were in the coma upon admission and 47% (24/51) presented pupil anomalies. KWNP presented the neuroimaging features of compression ischemic stroke located in the contralateral cerebral peduncle, with edema in the surrounding structures and sometimes compression stroke of the cerebral arteries passing nearby. 45% of the patients (23/51) presented a good motor functional outcome; nevertheless, no predisposing factor was identified. A Glasgow coma scale (GCS) of more than 3 showed a trend (p=0.1065) toward a better motor functional outcome. The KWNP is a regional compression syndrome oftentimes caused by sudden and massive uncal herniation and leading to contralateral cerebral peduncle ischemia. Even though patients suffering from KWNP usually present a good overall recovery, patients with a GCS of 3 may present a worse motor functional outcome. In order to better understand this syndrome, future studies will have to focus on more personalized criteria such as individual variation of tentorial notch width.

• The Journal of the Society of Stroke on Korean Medicine
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• v.16 no.1
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• pp.1-10
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• 2015

■ Objectives The purpose of this case study is to report that a tremor patient after Acute Cerebral infarction was treated with 'Dodamhwalhul-tang' and then the symptoms were improved. ■ Methods This patient was 81 years old woman whowas diagnosed with acute cerebral infarction. This patient had hypertension and symptoms of tremor on left lower limb, both side weakness, both lower limb numbness, dizziness and low back pain. She was treated with herb medicines, acupuncture, moxibustion during 22 days of hospitalization. Her tremor was evaluated by the tremor frequency and period and other general conditions were measured. ■ Results After taking Dodamhwalhul-tang, symtoms of tremor and patient's general conditions were improved. ■ Conclusion The result shows that Dodamhwalhul-tang is effective for tremor with acute cerebral infarction.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.6
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• pp.1552-1559
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• 2003

Objective : The purpose of this study was to identify the functional independence of cerebral vascular disease patients. Method : This clinical data is analyzed on 60 cases of the stroke patients diagnosed through Brain CT scan or MRI scan. at the Hospital affiliated to Oriental Medical College, Dongeui University, from March to July 2003. Result and Conclusion : This clinical data shows significant improvement with their functional independence in 4 weeks, comparing with the initial stage. Functional independence of cerebral vascular disease patients are related with Meridian System and Internal Organs, dysporia. dysuria, lacunar infartion. heart problem, past history therapy, pulse rate.

• Journal of Korean Neurosurgical Society
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• v.45 no.1
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• pp.43-45
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• 2009

A 75-year-old female presented with subarachnoid hemorrhage. Angiography revealed a partial duplication (fenestration) in the proximal $A_1$ segment and a ruptured aneurysm at the distal end of $A_1$ fenestration. This congenital anomaly accompanying an aneurysm was associated with duplicated ipsilateral middle cerebral artery (MCA). Congenital defect of the arterial wall and hemodynamic factors at the fenestrated $A_1$ are considered to play a significant role in the development of this aneurysm. The present case is peculiar because not only the ruptured $A_1$ aneurysm was related with the anterior and middle cerebral artery duplication but also the location of $A_1$ fenestration and the origin of $A_1$ aneurysm in a fenestration are quite unusual.