• Clinical and Experimental Pediatrics
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• 제46권10호
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• pp.1040-1043
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• 2003

저자들은 9세 남아에서 고혈압과 뇌혈관염이 동반된 상태에서 뇌증을 보인 HSP 신염 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Medicine and Life Science
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• 제21권1호
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• pp.15-19
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• 2024

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic necrotizing vasculitis that predominantly affects small vessels of the body. The two most common ANCAs are myeloperoxidase ANCA and proteinase 3 ANCA. Neurological manifestations are frequent in patients with AAV, including peripheral neuropathy, meningitis, and stroke. AAV-associated ischemic stroke usually affects small vessels supplying the white matter or brainstem. This case report details the presentation and treatment course of a 70-year-old man with rapidly progressive multiple intracranial large artery involvement attributed to myeloperoxidase ANCA-associated vasculitis. Despite treatment with high-dose steroids and a rituximab infusion, the patient developed new speech difficulties and respiratory distress, and brain imaging confirmed new stroke lesions with progressive multiple intracranial large cerebral artery involvement. The patient died from SARS-CoV-2 infection 4 months after the diagnosis. This case emphasized the rare presentation of rapidly progressive large vessel involvement in a patient with myeloperoxidase ANCA-associated vasculitis despite active immunotherapy.

• Clinical and Experimental Pediatrics
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• 제45권12호
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• pp.1601-1605
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• 2002

본 저자들은 경련과 의식저하를 보인 알레르기성 자반증 환아에서 신경학적 합병증으로 대뇌 동맥의 혈관염이 발생된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국산학기술학회논문지
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• 제18권10호
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• pp.178-184
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• 2017

본 연구는 2007년 1월부터 2015년 12월까지 본원에서 쯔쯔가무시병으로 진단을 받고 치료 중인 상태에서 뇌경색이 발생하거나, 뇌경색이 생겨 입원 치료를 받던 중 쯔쯔가무시병이 발견된 16명의 환자를 대상으로 하였다. 급성기 뇌경색의 진단은 뇌자기공명영상 및 뇌자기공명혈관영상으로 하였으며 쯔쯔가무시병의 진단은 PCR (Polymerase chain reaction)로 하였다. 일반적인 뇌경색과 쯔쯔가무시병을 동반한 뇌경색의 차이점을 구별하기 위해 내원시 혈압과 체온을 측정하여 보았다. 일반적으로 급성기 뇌경색에서는 혈압이 올라가는데 흥미롭게도 본 연구에서는 수축기 혈압이 130mmHg 미만인 환자가 12명으로 급성기 뇌경색에서 흔히 보이는 혈압 양상과는 다른 모습을 보였다. 쯔쯔가무시병을 동반한 뇌경색의 특징을 알아보기 위해 발병 위치 및 단일 혹은 다발성 뇌경색 여부를 확인하여 보았는데, 앞순환 동맥 영역의 뇌경색 발생 환자가 13명이었으며 뒤순환 동맥 영역의 뇌경색 발생 환자는 3명이었다. 응고장애를 진단하기 위해 트롬보플라스틴시간(Prothrombin Time, PT), 활성화부분트롬보플라스틴시간(activated partial thromboplastin time, aPTT), D-dimer, 섬유소원(fibrinogen), 섬유소분해산물(fibrin degradation product, FDP)를 기록하였다. 뇌경색시 일반적으로 수치가 증가하는 것으로 알려진 D-dimer의 경우 13명의 환자에서 큰 폭의 증가 소견을 보였다. 섬유소분해산물(FDP)는 15명의 환자에서 큰 폭의 증가 소견을 보였다. 쯔쯔가무시병의 병태생리학적 기전은 혈관염으로 알려져 있는데 이로 인한 대뇌혈관의 내피세포 손상 및 증식이 있을 수 있고 그 과정에서 응고장애가 동반되어 뇌경색이 발생할 수 있다. 또는 내피세포 손상 및 증식이 없더라도 혈관염으로 인한 혈관연축이 발생하여 혈관수축이 오며 뇌경색이 발생 할 수도 있다.

• Clinical and Experimental Pediatrics
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• 제62권9호
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• pp.334-339
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• 2019

Kawasaki disease (KD) is a systemic vasculitis in infants and young children. However, its natural history has not been fully elucidated because the first case was reported in the late 1960s and patients who have recovered are just now entering middle age. Nevertheless, much evidence has raised concerns regarding the subclinical vascular changes that occur in post-KD patients. KD research has focused on coronary artery aneurysms because they are directly associated with fatality. However, aneurysms have been reported in other extracardiac muscular arteries and their fate seems to resemble that of coronary artery aneurysms. Arterial strokes in KD cases are rarely reported. Asymptomatic ischemic lesions were observed in a prospective study of brain vascular lesions in KD patients with coronary artery aneurysms. The findings of a study of single-photon emission computed tomography suggested that asymptomatic cerebral vasculitis is more common than we believed. Some authors assumed that the need to consider the possibility of brain vascular lesions in severe cases of KD regardless of presence or absence of neurological symptoms. These findings suggest that KD is related with cerebrovascular lesions in children and young adults. Considering the fatal consequences of cerebral vascular involvement in KD patients, increased attention is required. Here we review our understanding of brain vascular involvement in KD.

• Tuberculosis and Respiratory Diseases
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• 제51권6호
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• pp.603-608
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• 2001

저자들은 속립성 폐결핵과 연관되어 급성 경과를 보인 결핵성 뇌수막뇌염 환자에서 뇌혈관 자기공명영상으로 혈관염 소견을 확인하고, 스테로이드의 투여와 중단, 재투여에 따라 뇌증의 증세가 뚜렷히 변하는 임상경과, 증상이 호전된 후 추적한 뇌혈관 자기공명영상에서 혈관 영상이 정상화된 것을 확인할 수 있었던 사례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 생물정신의학
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• 제2권2호
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• pp.301-305
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• 1995

Subcortical dementia may occur as a complication of cerebral malaria via deep white matter demyelination with encephalitis and diffuse small vessel vasculitis. In subcortical dementia, impairment in attention and frontal executive function are predominant. Patients are often inert, indifferent, and uninterested. They appear characteristically 'slowed up' with a marked deficit in the retrieval of information. Changes in mood, personality, and social conduct are very common. We describe a case of subcortical dementia, who has definite changes in brain MRI after cerebral malaria.

• Physical Therapy Rehabilitation Science
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• 제5권2호
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• pp.106-112
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• 2016

Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.

• Journal of Korean Neurosurgical Society
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• 제58권5호
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• pp.471-475
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• 2015

Intracerebral hemorrhage (ICH) is common among various types of storkes; however, it is rare in young patients and patients who do not have any risk factors. In such cases, ICH is generally caused by vascular malformations, tumors, vasculitis, or drug abuse. Basal ganglia ICH is rarely related with distal lenticulostriate artery (LSA) aneurysm. Since the 1960s, a total of 29 distal LSA aneurysm cases causing ICH have been reported in the English literature. Despite of the small number of cases, various treatment methods have been attempted : surgical clipping, endovascular treatment, conservative treatment, superficial temporal artery-middle cerebral artery anastomosis, and gamma-knife radiosurgery. Here, we report two additional cases and review the literature. Thereupon, we discerned that young patients with deep ICH are in need of conventional cerebral angiography. Moreover, initial conservative treatment with follow-up cerebral angiography might be a good treatment option except for cases with a large amount of hematoma that necessitates emergency evacuation. If the LSA aneurysm still persists or enlarges on follow-up angiography, it should be treated surgically or endovascularly.

• 대한신경과학회지
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• 제36권4호
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• pp.337-340
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• 2018

Human immunodeficiency virus (HIV) infection can result in ischemic stroke via several mechanisms, including opportunistic infection, vasculopathy, cardioembolism, and coagulopathy. HIV-vasculopathy is related to endothelial dysfunction, stenosis and aneurysm formation, infectious vasculitis, dissection and accelerated atherosclerosis during highly active antiretroviral therapy (HAART). We represent a case of HIV infection manifested as an acute ischemic stroke attack. After 4 months during HAART, our patient experienced a recurrent ischemic stroke with progression of middle cerebral artery stenosis.