• Title/Summary/Keyword: Cerebral stroke

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Transcatheter Embolotherapy of Giant Pulmonary Arteriovenous Malformation Using Amplatzer® Vascular Plug (Amplatzer® 혈관폐색장치를 이용한 거대 폐동정맥기형 색전술 1예)

  • Jung, Ki Hwan;Lee, Seung Hwa;Shin, Chol;Kim, Je Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.52-58
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    • 2009
  • Pulmonary arteriovenous malformation (PAVM) is a rare pulmonary vascular anomaly due to an abnormal communication between the pulmonary artery and vein. The most common presenting symptom is a dyspnea on exertion related to this right-to-left shunt. If left untreated, PAVM has been known to result in serious complications. Incomplete pulmonary capillary network can be the cause of cerebral abscesses and other noninfectious neurological complications, such as stroke and transient ischemic attacks due to paradoxic embolism Transcatheter embolotherapy, using coils or balloons, has replaced surgical resection as the treatment of choice for PAVM. However, the risk of device embolization has limited the use of coil embolotherapy, while the size of PAVM is huge. Recently, Amplatzer$^{(R)}$ Vascular Plug has been proposed as an alternative endovascular occlusion device for arteriovenous malformation. We report a case of 81-year-old male patient with a giant PAVM, which was successfully treated by transcatheter embolotherapy using the Amplatzer$^{(R)}$ Vascular Plug.

Prescribing Patterns of Pain Medication in Hospitalized Elderly Patients with Non-Cancer Pain (노인 입원 환자의 비암성 통증에 대한 약물 처방 현황)

  • Nam, Ki Nam;Choi, Eun Ok;Kim, Beam Hae;Seong, Sae Ra;Heo, Yoo Jeong;Lee, Kyeong Ju;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.145-150
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    • 2015
  • Objective: Pain is very common in the elderly, so there is a high prevalence of analgesic use among this population. The purpose of this study was to assess patterns of analgesic use and evaluate factors associated with analgesic use in elderly patients. Method: The subjects of this study were patients over 65 years old hospitalized in a teaching hospital located in Chuncheon-si, Korea between January 1, 2014 and March 31, 2014. Data collection regarding analgesic prescriptions and baseline characteristics was conducted using computerized hospital database by medical information team. Logistic regression analysis was used to identify factors related to analgesic use. Results: A total of 2,394 patients were finally included. Among these patients, 700 (29.2%) took analgesics; 521 (74.4%) out of these 700 patients were received opioid analgesics and 179 (25.6%) were received only non-opioid analgesics. The most frequently prescribed opioid analgesic was pethidine (45.7%), and the most frequently prescribed non-opioid analgesic was acetaminophen (44.1%). Fracture was associated with increased odds of opioid analgesic prescriptions (OR = 2.766, 95% CI = 2.019-3.790, p < 0.001) and any analgesic prescriptions (OR = 2.394, 95% CI = 1.766-3.244, p < 0.001). Stroke or cerebral infarction was associated with decreased odds of opioid analgesic prescriptions (OR = 0.636, 95% CI = 0.471-0.858, p = 0.003). Conclusion: A significant proportion of hospitalized elderly patients use analgesics. Health care professionals should consider factors associated with analgesic use in this population to improve pain management.

Case Reports about Brainstem Infarction -Dejerine′s syndrome and Wallenburg′s syndrome- (뇌간 경색에 대한 고찰 -Dejerine′s syndrome 1례 및 Wallenburg′s syndrome 1례-)

  • Cho Gwon Il;Han Myoung Ah;Lee Ji Yeon;Choi Jin Young;Kim Dong Woung;Jung Dae Young;Kim Kwan Sik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.6
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    • pp.1291-1296
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    • 2002
  • Blood circulation of brain is divided into two major categories; anterior one from carotid artery and posterior one from vertebrobasilar artery. In stroke patients, it is important to diagnose which is involved, because there is many difference in the aspects of clinical menifestations and prognosis, especially in the acute stage. In some cases of vertebrobasilar infarction, such as Wallenberg's syndrome, charicteristic cranial nerve signs, eye movement disorders and cerebellar signs are appeared. And in Dejerine's syndrome, only pure motor or sensory defecits can be appeared without any brainstem signs. So It shoud be differenciated by Brain MRI from those of the cerebral hemisphere lesions. And in the cases that nausea, vomitting and dysphagia are the first menifestations, it is frequently misdiagnosed as internal medical disease, causing appropriate treatment delayed. In this case report, we are to describe the clinical menifestations and progresses of two cases of brainstem infarctions, review previously published case reports about them and compare them to our cases. The first is Dejerine's syndrome i.e. medial medullary infarction, the second is Wallenberg's syndrome i.e. lateral medullary infarction. Simultaneously we are to investigate the oriental medical approach in the bran stem infarctions.

Protocols and Results of Resident Neurosurgeon's Transfemoral Catheter Angiography Training Supervised by Neuroendovascular Specialists

  • Shin, Dong-Seong;Yeo, Dong-Kyu;Hwang, Sun-Chul;Park, Sukh-Que;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.81-85
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    • 2013
  • Objective : Transfemoral catheter angiography (TFCA) is a basic procedure in neurovascular surgery with increasing importance in surgical and non-invasive treatments. Unfortunately, resident neurosurgeons have relatively few opportunities to perform TFCA in most institutions. We report a method developed in our hospital for training resident neurosurgeons to perform TFCA and evaluate the efficacy of this training. Methods : From May 2011 to September 2011, a total of 112 consecutive patients underwent TFCA by one resident neurosurgeon supervised by two neuroendovascular specialists. Patients who underwent elective diagnostic procedures were included in this study. Patients who underwent endovascular treatment were excluded. Demographic data, indications for TFCA, side of approach, number of selected arteries, and complications were analyzed. Results : This study included 64 males and 48 females with a mean age of 51.6 (12-81) years. All procedures were performed in the angiography suite. Common indications for procedures were as follows : stroke-induced symptoms in 61 patients (54.5%), Moyamoya disease and arteriovenous malformation in 13 patients (11.6%), and unruptured intracranial aneurysm in eight patients (7.1%). Right and left femoral puncture was performed in 98.2% and 1.8% of patients, respectively. A total of 465 selective angiographies were performed without complications. Angiographic examination was performed on 4.15 vessels per patient. Conclusion : TFCA can be performed safely by resident neurosurgeons based on anatomical study and a meticulous protocol under the careful supervision of neuroendovascular specialists.

A Study on the Radiation Exposure Dose of Brain Perfusion CT Examination a Phantom (Phantom을 이용한 뇌 관류 CT검사에서 방사선 피폭선량에 관한 연구)

  • Jung, Hong-Rynag;Kim, Ki-Jeong;Mo, Eun-Hee
    • Journal of the Korea Convergence Society
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    • v.6 no.5
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    • pp.287-294
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    • 2015
  • The purpose of this study, was Let's examine the exposure dose at the time of cerebral blood flow CT scan of acute ischemic stroke patients. In particular, long-term high doses of radiation sensitive organs and we Measured using phantom and a glass dosimeter. Apply the existing protocol suggested by the manufacturer (fixed time delay technique) and the proposed new convergence protocol (bolus tracking technique), reporting to measure the dose, dose reduction was to prepare the way. Results up to 39.8% as compared to the existing protocols in a new suggested convergence protocol, a minimum of 5.8% was long-term dose is reduced. Test dose of $CDTI_{vol}$ and DLP values decreased 25%, respectively, were measured at less than recommended dose. Try checking the protocol set out in the existing based on the analysis result of the above, by applying the proposed new convergence protocol by reducing the dose would have to contribute to improved public health. It is believed to be research continues to find the optimum protocol in the other tests.

A Case Report of Hyperlipidemia and Constipation in a Patient with Cerebral Infarction Treated with Herbal Prescription. (뇌경색 후유증 환자의 고지혈증과 변비에 대한 함초환(鹹草丸) 호전 1례)

  • Woo, Sung-Ho;Kim, Byung-Chul;Kim, Jin-Won;Jeong, Byeong-Ju;Na, Eu-Jin;Shim, Hyo-Ju;Kim, Yong-Ho;Seo, Ho-Seok;Lee, Won-Hui
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.945-953
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    • 2006
  • Hyperlipidemia is one of the major factors causing the atherosclerosis of coronary arteries and a well-documented modifiable risk factor for stroke, especially of the ischemic type. Constipation is the condition of being unable to empty the bowels frequently enough or effectively. However, it is usually temporary and not a serious disease. Salicornia herbacea is a sea coast plant that grows on the western and southern coastal beaches and salt flats of the Korean peninsula. Belonging to Chenopodiaceae by biological classification. Salicornia herbacea is not known from research except that it contains plenty of minerals. The purpose of this study was to evaluate the effect of treatment with Hamcho-hwanand to observe changes in total cholesterol (T-Chol) high-density lipoprotein cholesterol (HDL), triglyceride (TG) and constipation. After treatment, total cholesterol decreased from 273mg/dl to 235mg/dl. Triglyceride decreased from 201mg/dl to 126mg/dl. HDL cholesterol increased from 30mg/dl to 40mg/dl. Constipation changed for the better. These results support a role for oriental medical therapy in treating hyperlipidemia and constipation. Further case studies of herbal treatment of this ailment are needed.

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Neuroprotective Effects of KC0244, a Glycine Site Antagonist, in a Rat Model of Transient Focal Ischemia

  • Ku, Hee-Jung;Churlmin Seong;Park, No-Sang;Changbae Jin
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1998.11a
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    • pp.143-143
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    • 1998
  • Antagonists acting at the glycine site of the NMDA receptor have been gaining safer alternatives for stroke therapy because they have few adverse effect competitive and noncompetitive NMDA antagonists. Therefore, the neuroprotect novel glycine site antagonist KC0244 were evaluated in a rat model of transient comparison with GV150526A in a developmental phase. Middle cerebral artery oc was produced by insertion of a silicone-coated 4-0 nylon monofilament to the o in male Sprague-Dawley rats under isoflurane anesthesia. After 90 or 120 min retracted and the ischemic tissue reperfused. In 90-min MCAO model, GV150526A was administered 30 min before MCAO or immediately after MCAO. In 120-min MC KC0244 or GV150526A (10 mg/kg, i.p.) was administered 1 hr before MCAO or imme MCAO. Infarct volume was measured 24 hr after MCAO using the 2,3,5-triphe chloride staining method. In 90-min MCAO model, treatments with GV1505 significantly reduce infarct volume although they tended to slightly reduce cor approximately 19% compared with the nontreated group. In 120-min MCAO model with GV150526A did not either significantly reduce infarct volume although the reduce total infarct volume by approximately 16% compared with the vehicle-tre However, 1-hr preischemic and immediate treatments with KC0244 reduced total i 39 and 30% (corrected total infarct volume by 44 and 32%), respectively, co vehicle-treated control group. The results suggest that KC0244 can provid against transient focal ischemic damage with greater in vivo potency than GV150

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A Review of Spatial Neglect: Types, Theories, Neuroanatomy, Assessments and Treatment (편측 공간무시에 관한 고찰: 유형 및 이론, 해부학적 영역, 평가와 치료)

  • Jeong, Eun-Hwa
    • Therapeutic Science for Rehabilitation
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    • v.6 no.1
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    • pp.11-23
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    • 2017
  • Spatial neglect is a neurological disorder following stroke, a lesion that usually affects the right hemisphere, fail to process or attention on the contralateral side of body and space. Functional neuroimaging studies report that spatial neglect is associated with lesions of large middle cerebral artery, perisylvian network and attention network. Spatial neglect is associated with a poor outcome. For optimal diagnosis and intervention, Types and theories of spatial neglect should be considered, in addition to clinical assessment with the conventional test and functional test. The treatment for spatial neglect could be consist of top-down approaches and bottom-up approaches. Recent trends in rehabilitation intervention for spatial neglect have reported prism adaptation.

Traumatic Brain Injury in a Pomeranian Dog: Clinical, Computed Tomography, and Necropsy Findings (포메라니언 종에서 발생한 외상성 뇌손상 증례보고; 임상적, 전산화 단층촬영, 부검 소견)

  • Lee, Hee-Chun;Choi, Eul-Soo;Cho, Kyu-Woan;Kang, Byeong-Teck;Kim, Ju-Won;Yu, Chi-Ho;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.579-583
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    • 2010
  • An 18-month-old intact male Pomeranian dog was presented because of traumatic head injury from a fall. Based on physical and neurological examination, brain injury was suspected. On plain skull radiographs, bony fragment following fracture was identified in the region of the right occipital bone. On computed tomography (CT) images, there were specific findings associated with an intracranial hemorrhage. The patient expired few hours after diagnosis, and performed necropsy. On gross findings, intracerebral hemorrhage and edema was detected and those were consistent with CT images. This report describes the clinical findings, CT imaging characteristics, necropsy findings, and histopathologic features of severe traumatic brain injury in a dog.

Melkersson-Rosenthal Syndrome -Report of a Case- (Melkersson-Rosenthal Syndrome -증례보고-)

  • Kim, Tae-Jung;Park, Wook;Lee, Sung-Keun;Kim, Il-Ho;Song, Hu-Bin;Hwang, Kyung-Ho;Kim, Sun-Chong;Kim, Sung-Yul
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.57-60
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    • 1989
  • The Melkersson-Rosenthal (M-R) syndrome consists of a triad of (1) recurrent peripheral facial nerve paralysis which develops alternately on both sides of face, (2) non-inflammatory facial edema, and (3) fissuring of tongue. A 59 years old female patient developed the left facial palsy on September, 1988. Right facial palsy developed continuously 2 months later after the spontaneous remission of left facial palsy. On February, 1989, we have found out M-R syndrome which accompanied with migraine type of intermittent headache, and hypertension in one attack of cerebral stroke several years ago, there were no diabetes mellitus, pulmonary tuberculosis and brain tumor in clinical studies. Although the causes of this syndrome were not noted, we performed the stellate ganglion block and transcutaneous electrical nerve stimulation for treatment of the palsy, but the clinical effectiveness of these were not satisfactory.

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