• Title/Summary/Keyword: Cerebral stroke

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Thromboxane A2 Synthetase Inhibitor Plus Low Dose Aspirin : Can It Be a Salvage Treatment in Acute Stroke Beyond Thrombolytic Time Window

  • An, Gyu-Hwan;Sim, Sook-Young;Jwa, Cheol-Su;Kim, Gang-Hyeon;Lee, Jong-Yun;Kang, Jae-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.50 no.1
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    • pp.1-5
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    • 2011
  • Objective : There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. Methods : Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. Results : There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. Conclusion : In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.

Hyperperfusion in DWI Abnormality in a Patient with Acute Symptomatic Hypoglycemic Encephalopathy

  • Park, Ji Kang
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.2
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    • pp.106-108
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    • 2017
  • The perfusion change in acute symptomatic hypoglycemic encephalopathy (ASHE) is not well known. We present the perfusion-weighted imaging of a patient with ASHE. The area of diffusion-weighted imaging abnormalities and adjacent normal-appearing white matter showed increased cerebral blood volume and flow, and shortening of time-to-peak.

Review on Laser or LED Therapy for the Photobiomodulation of Diseases of the Cerebral Nervous System (뇌신경질환에 사용된 레이저 및 광선치료에 대한 임상 연구 고찰)

  • Lee, Kyung-Goo;Shin, Jong-Hun;Lee, Kyung-Jin;Sun, Seung-Ho;Han, Chang-Ho;Jang, In-Soo
    • The Journal of Internal Korean Medicine
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    • v.35 no.4
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    • pp.546-555
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    • 2014
  • Objectives: Recently, many studies have reported beneficial effects from the application of laser and light-emitting diode (LED) therapy for cerebral nervous disease. Transcranial laser therapy and LED therapy may be an effective method to treat diseases of the cerebral nervous system. This study aims to discuss the possibility of laser and LED therapy for cerebral nervous disease by reviewing literature about its effectiveness. Methods: We searched papers using PubMed, Science Direct, CINAHL, KTKP, Oasis and NDSL, using the keywords "Laser therapy, low-level", "Transcranial laser", "Transcranial light emitting diode" and "stroke", "traumatic brain injury", "dementia", "anxiety", "cognitive", "emotional effects", "psychiatric disorder", "multiple sclerosis", "Parkinson's disease". The search range included randomized controlled trials (RCTs) and clinical case series. Reviews and animal experiments were not included. Studies not matched with inclusion criteria were excluded. Results: A total 1,119 studies were found. 1,100 were excluded from scanning titles and abstracts and finally 9 articles were selected. Among the 9 articles, 5 were RCTs, one was a controlled study, and the other 3 were case reports. They reported that transcranial laser therapy and LED treatment had beneficial effects from photobiomodulation to the cerebral nervous system. Clinical evaluation factors showed favorable trends. Conclusions: Transcranial laser therapy and LED therapy seem to be effective to the cerebral nervous system and they may be a favorable choice for cerebral nervous disease.

Risk Assessment of Smoking for Ischemic Stroke in Koreans

  • Jung, Woo-Sang;Choi, Byung-Ok;Park, Jung-Mi;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Korean Medicine
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    • v.24 no.4
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    • pp.19-24
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    • 2003
  • Background and Purposes : Smoking is a well-known risk factor for ischemic stroke. It may contribute to s1Toke by inducing the aggregation of platelets and formation of atheroma, reducing cerebral blood flow, and increasing fibrinogen. However, the relative risk varies according to different ethnicity and area. Therefore, we performed this study to assess the risk of smoking for ischemic s1Toke in Korea. Methods : Cigarette smoking habit was studied in 308 patients with ischemic s1Toke and in 348 age- and sex-matched control subjects who had no history of stroke using case control methods. In multiple logistic regression analysis, smoking had a significant value of odds ratio adjusted for hypertension, diabetes mellitus, and hyperlipidemia. Results : The adjusted odds ratio (AOR) and 95% confidence interval (CI) was significant in the medium smokers (AOR, 1.92; 95% CI, 1.11 to 3.33: p< 0.05) and heavy smokers (AOR, 2.80; 95% CI, 1.64 to 4.78: p< 0.05). Furthermore, the OR was higher in hypertensive subjects than in normotensive subjects compared to non-smokers (AOR, 1.98; 95% CI, 1.01 to 3.85: p< 0.05). Conclusions : Our findings suggest that smoking is an independent risk factor for ischemic stroke in Korea.

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A Case of Cerebral Infarction Patient Complaining Post-Stroke Aggression Accompanying Anxiety Treated with Combined Korean Medical Treatment (뇌졸중 후 불안을 동반한 공격성을 호소하는 뇌경색 환자에 대한 복합 한의치험 1례)

  • Dabin Lee;Seon-Uk Jeon;Geun Young Kim;Ki-Ho Cho;Sang-Kwan Moon;Woo-Sang Jung;Seungwon Kwon;Han-Kyul Lee
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.24 no.1
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    • pp.67-76
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    • 2023
  • Post-stroke aggression refers to aggressive behaviors and languages which are occurred after stroke. In stroke patients, over 15% suffer from the anger and the symptom lowers the quality of life of the patients, family, and caregivers. After diagnosing post-stroke aggression, selective serotonin re-uptake inhibitor(SSRI) and beta-blocker, beta adrenergic agonist treatment usually underwent to treat the anger and anxiety of the patient. In the present case, a 81-year-old female patient with post-stroke aggression underwent Korean medical treatment by Jodeungsan and Ukgansan for 49 days. The effect of the treatment was assessed with State-Trait Anger Expression Inventory(STAXI) per a week, roaming time per a week and roaming frequency per a week. After the treatment, STAXI score, roaming time, and roaming frequecy decreased, and the patient could successfully cease to take beta-blocker, which she started to take for treating her aggression, without any side-effects. This case report suggests that Ukgansan might be an effective option with post-stroke aggression patients taking medication including beta-blocker.

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A Clinical Study about Distribution of Serum Lipid Density on Stroke Patients (졸중풍(卒中風) 환자(患者)에 있어 혈중지질(血中脂質)의 분포(分布) 상황(狀況)에 대한 임상적(臨床的) 고찰(考察))

  • Chou, Li-Shan;Jung, Hyun-Ji;Han, Chang-Ho;Yoo, Jae-Yeon
    • The Journal of Internal Korean Medicine
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    • v.21 no.4
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    • pp.583-590
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    • 2000
  • Objective : The major risk factors of stroke are hyperlipemia, ateriosclerosis, hypertension, diabetis mellitus, smoking, drinking, age, personal history, family history etc. Hypertension, smoking and hyperlipemia are very important factor to promote stroke. We intended to observe the serum lipid density of 51 patients come to Joongpoong & Chronic Disease Center of Conmaul Oriental hospital, comparing with already reported study. Methods : We studied 51 stroke-patients( 38 cerebral infarction, 13 intracerebral hemorrhage) of Conmaul Oriental hospital, Department of oriental internal medicine, Joongpoong & Chronic Disease Center from January 1. 1999 to August 31. 2000, which examined by neurologic test, brain-CT, brain-MRI. . We used DOSHISA TBA-30FR(Japan) as instrument for measuring total cholesterol and triglyceride of serum. Results and conclusions : The results are as follows 1. The rate of hyperlipemia and presumed-hyperlipemia is higher in female patient-group than male patient-group. 2. The rate of hyperlipemia and presumed-hyperlipemia is higher in drinking group than non-drinking group. 3. The rate of hyperlipemia and presumed-hyperlipemia is higher in hypertension group than normotention group.

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A Case of Moyamoya Disease (모야모야병 환아(患兒) 1예(例)에 대한 증례(症例))

  • Yu Sun-Yae;Lee Seung-Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.2
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    • pp.141-147
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    • 2000
  • Moyamoya is a chronic cerebrovascular disease chracterized by progressive stenosis or occlusion of the terminal parts of both internal carotid arteries with telangiectatic vascular network of collateral circuration at the base of the brain and leptomeningeal arteries. The etiology and pathophysiology of this disease are still unknown. The clinical course in those whose first symptoms occur in childhood is different from those in whom symptoms develop in adult life. The term moyamoya disease should be resserved for those cases in which the chracteristic angiographic pattern is idiopathic; moayamoya syndrome is used when the underlying condition is known. we have experienced a case of moyamoya syndrome in a 5-year-2-month-old boy who presented right-sided hemiparesis. A cerebral angiogram revealed occlusion of abnomal collateral network. Moyamoya disease is applicable to stroke of an infant from oriental medicine point of view, and The symptoms is similar to adult stroke, we have treated adult stroke patint with herb medicine and acupuncutre and physical treatment. The acute stage of stroke is applied to the external treatment(標治), and The recovery stage is applied to the basic treament(本治).

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Oleanolic Acid Provides Neuroprotection against Ischemic Stroke through the Inhibition of Microglial Activation and NLRP3 Inflammasome Activation

  • Sapkota, Arjun;Choi, Ji Woong
    • Biomolecules & Therapeutics
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    • v.30 no.1
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    • pp.55-63
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    • 2022
  • Oleanolic acid (OA), a natural pentacyclic triterpenoid, has been reported to exert protective effects against several neurological diseases through its anti-oxidative and anti-inflammatory activities. The goal of the present study was to evaluate the therapeutic potential of OA against acute and chronic brain injuries after ischemic stroke using a mouse model of transient middle cerebral artery occlusion (tMCAO, MCAO/reperfusion). OA administration immediately after reperfusion significantly attenuated acute brain injuries including brain infarction, functional neurological deficits, and neuronal apoptosis. Moreover, delayed administration of OA (at 3 h after reperfusion) attenuated brain infarction and improved functional neurological deficits during the acute phase. Such neuroprotective effects were associated with attenuation of microglial activation and lipid peroxidation in the injured brain after the tMCAO challenge. OA also attenuated NLRP3 inflammasome activation in activated microglia during the acute phase. In addition, daily administration of OA for 7 days starting from either immediately after reperfusion or 1 day after reperfusion significantly improved functional neurological deficits and attenuated brain tissue loss up to 21 days after the tMCAO challenge; these findings supported therapeutic effects of OA against ischemic stroke-induced chronic brain injury. Together, these findings showed that OA exerted neuroprotective effects against both acute and chronic brain injuries after tMCAO challenge, suggesting that OA is a potential therapeutic agent to treat ischemic stroke.

A case of Early Neurological Recovery from Stroke by Recannalization in Early Stage (조기 혈관 재개통으로 뇌졸중 초기에 회복을 보인 환자 1예)

  • Kim, Jin-ah;Park, Jung-mi
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.6 no.1
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    • pp.63-68
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    • 2005
  • Objective: The purpose of this case study is to show a case of early neurological recovery from stroke by recannalization. Methods: The patient was admitted from 12 July, 2004 to 26 July, 2004. The patient received Herb-Medication and Acupuncture Therapy. Brain MRI and Tc-99m HM-PAO brain SPECT was used to diagnose and prognose. Results: The patient fully recovered within a few hours. She was diagnosed as acute infarction in Lt. BG by using brain MRI. Tc-99m HM-PAO brain SPECT showed focal increased perfusion at Lt. BG. Conclusions: We suggest that the important thing to recovery from stroke is recannalization of cerebral arteries in early stage.

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Endovascular recanalization therapy for patients with acute ischemic stroke with hidden aortic dissection: A case series

  • Hye Seon Jeong;Eun-Oh Jeong;In Young Lee;Hak In Lee;Hyeon-Song Koh;Hyon-Jo Kwon
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.3
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    • pp.333-339
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    • 2023
  • Aortic dissection is one of the causes of acute ischemic stroke. Endovascular recanalization therapy (EVT) has emerged as an essential treatment for acute ischemic stroke due to large artery occlusion. However, it is rarely performed in the situation of hidden aortic dissection (AD). Two patients presented to the emergency room with focal neurologic deficits. The first patient was diagnosed with right internal carotid artery (ICA) occlusion. Angiography revealed that the ICA was occluded by the dissection flap. After a stent deployment in the proximal ICA, the antegrade flow was restored. The patient was diagnosed with AD on chest computed tomography (CT) after EVT. For the second patient, intraarterial thrombectomy was performed to treat left middle cerebral artery occlusion. AD was first detected on echocardiography, which was performed after EVT. Herein, we report successful endovascular recanalization therapy performed in two patients with acute ischemic stroke in the situation of undiagnosed aortic dissection. We also reviewed previous case reports and relevant literature.