• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.502-508
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• 2022

Objective: Contralateral seventh cervical nerve transfer (contralateral C7 transfer) is a newly attempted method to restore upper extremity motor function in the patients with spastic arm paralysis. The aim of this study was to investigate the effects of contralateral C7 transfer on upper extremity motor function in the patients with spastic hemiplegia after stroke. Design: A retrospective cohort study. Methods: Thirty-four patients with spastic hemiplegia after stroke was investigated. All patients registered between January 2020 and February 2021. The subjects were assessed on upper extremity motor function, cognition, and spasticity before and after contralateral C7 transfer. The upper extremity motor function was measured using the Fugl-Meyer upper extremity scale and box & block test. The cognition and spasticity were assessed by Korean version mini mental state examination (K-MMSE) and modified Ashworth scale from baseline to 8 weeks after the surgery. Results: The Fugl-Meyer upper extremity scale and modified Ashworth scale were significantly improved after contralateral C7 transfer (p<0.05). However, box & block test and K-MMSE were no significant changes after the surgery (p>0.05). Conclusions: This study suggested that the contralateral C7 transfer was a feasible and practical approach to improve upper extremity motor function in the patients with spastic hemiplegia after stroke, but further study is required to identify the long-term effects after the contralateral C7 transfer.

• Journal of Korean Neurosurgical Society
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• v.30 no.12
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• pp.1361-1368
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• 2001

Objective : "Paraclinoid" aneurysms include those aneurysms arising from the internal carotid artery between the site of emergence of the carotid artery from the roof of the cavernous sinus and the origin of the posterior communicating artery. The authors reviewed and analysed the results of surgical approaches to paraclinoid aneurysms treated with transcranial surgery and endovascular surgery. Methods : Between January 1998 and May 1999, 14 patients were treated surgically through ipsilateral and contralateral pterional approaches, and anterior interhemispheric approach, and endovascular surgery for paraclinoid aneurysms. All transcranial approaches were performed by same surgeon. The medical records, neuroimaging studies and videotapes which had been recorded operations were reviewed retrospectively. Results : Twelve patients presented with subarachnoid hemorrhage and ICH. Nine of fourteen patients had multiple aneurysms. Thirteen cases were small and one was a large aneurysm. Six patients were treated through ipsilateral approaches, six contralateral pterional approaches, one anterior interhemispheric approach and one primarily by GDC embolization. All aneurysms treated through contralateral approaches were multiple aneurysms. Neck clipping was performed in 9(69.2%) of the thirteen aneurysms, wrapping in four cases, among them three cases were followed by GDC embolization. The surgical outcomes were : Glasgow Outcome Scale(GOS) I 71.4%, GOS II 21.4% and GOS V 7.1%. Conclusion : The surgical approaches to paraclinoid aneurysms should be chosen after careful anatomical evaluation of aneurysm and its neighboring structures. 3D-CT angiography and/or the raw data of MR angiography were useful. This study supports the usefulness of the contralateral approach to paraclinoid aneurysm associated with multiple aneurysms, unruptured and small aneurysms whose dome projecting medially, superiorly and dorsally. The determination of contralateral approach to small and medially projecting paraclinoid aneurysm may be stressful to operator, thus we believe anterior interhemispheric approach is better alternated. Also we recommend the endovascular surgery after reinforcement of aneurym neck and dome in the case with difficulty in clipping.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.13 no.2
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• pp.200-210
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• 2000

objective to ascertain whether the concept of the therapeutic side is associated with changes in the blind sport mapping that represents the brain function. design Physiological blind spot maps were used as an integer of brain activity before and after acupuncture needling on the meridian point Hapkok(合谷) and Techung(太衝) in the unilateral side decided by double-blind controlled study(20 subjects). setting outpatient clinic participants: adult volunteers intervention twenty subjects were divided into two comparative groups and underwent specific acupuncture therapy on the unilateral side. Blinded examiners obtained reproducible pre and post-acupuncture cortical maps, which were subjected to statistical analysis. main outcome measures Brain activity was demonstrated by reproducible circumferential measurements of cortical hemispheric blind spot maps before and after acupuncture on the unilateral side. in case of acupuncture needling on the ipsilateral side of an enlarged side of bilnd spot, there were reduction of blind spot in 7 cases of 10 subjects, and enlargement in 3 cases. in case of acupuncture needling on the contralateral side of the enlarged side of blind spot, there were enlargement of blind spot in 6 cases of 10 subjects, and reduction in 4 cases. results the significant changes in the blind spots before and after acupuncture were observed Acupuncture needlings on the ipsilateral or contralateral side of an enlarged cortical map were associated with the concept of the therapeutic side traditionally accepted in the oriental medical society. Acupuncture needling on the ipsilateral side of an enlarged blind spot map is associated with the reduction of map, and increaed contralateral cortical activity. Acupuncture needling on the side opposite an enlarged blind spot map is associated with the enlargement of map, and decreased cortical activity. conclusion Reproducible maps of cortical responses can be used to measure the neurological consequences of acupuncture needling. Acupuncture can affect the somatic sensory informations that reach to the contralateral thalamus, and so affect thalamic integration. we found that acupuncture therapy may be associated with an increase or a decrease in brain function depending on the side of acupuncture needling. thus, the traditional concept of the contralateral therapeutic theory in acupuncture approach has the clinical significance in the view of brain function.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.231-233
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• 2006

The C2 level is the transition zone between the cranial and cervical spine. Because of its high position and anatomic relationship to vital structures, exposing C2 is challenging and the surgical approach is controversial. We report a of a recurred chordoma in C2 portion, occupying the osseous intraspinal portion. The patient underwent total corpectomy of C3 and gross total removal of tumor by right submandibular approach 3 years previously. We performed a lateral extrapharyngeal approach from contralateral left side with resection C2 central portion followed by gross total removal of mass and placement of graft bone. Although there was transient hypoglossal nerve palsy postoperatively, the patient had full recovery.

• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.220-224
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• 2017

Objective : This study aimed to unravel the putative mechanism underlying the neurologic deficits contralateral to the side with lumbar disc herniation (LDH) and to elucidate the treatment for this condition. Methods : From January 2009 to June 2015, 8 patients with LDH with predominantly contralateral neurologic deficits underwent surgical treatment on the side with LDH with or without decompressing the symptomatic side. A retrospective review of charts and radiological records of these 8 patients was performed. The putative mechanisms underlying the associated contralateral neurological deficits, magnetic resonance imaging (MRI), electromyography (EMG), and the adequate surgical approach are discussed here. Results : MRI revealed a similar laterally skewed paramedian disc herniation, with the apex deviated from the symptomatic side rather than directly compressing the nerve root; this condition may generate a contralateral traction force. EMG revealed radiculopathies in both sides of 6 patients and in the herniated side of 2 patients. Based on EMG findings and the existence of suspicious lateral recess stenosis of the symptomatic side, 6 patients underwent bilateral decompression of nerve roots and 2 were subjected to a microscopic discectomy to treat the asymptomatic disc herniation. No specific conditions such as venous congestion, nerve root anomaly or epidural lipomatosis were observed, which may be considered the putative pathomechanism causing the contralateral neurological deficits. The symptoms resolved significantly after surgery. Conclusion : The traction force generated on the contralateral side and lateral recess stenosis, rather than direct compression, may cause the contralateral neurologic deficits observed in LDH.

• PNF and Movement
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• v.10 no.4
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• pp.25-31
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• 2012

Purpose : The purpose of present study was to investigate the effects of proprioceptive neuromuscular facilitation (PNF) lifting on contralateral leg muscle activities in a seated position. Methods : Twenty healthy subjects were recruited for this study. Lifting was performed from each of the three position. An surface electromyogram (EMG) was used to record the EMG activities from vastus medialis (VM), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius medialis (GM) in contralateral leg muscle. The data were analyzed using a repeated measures of one-way analysis of variance (ANOVA) with post-hoc Bonferroni's correction to determine the statistical significance. Results : The results of this study were summarized as follows: In comparison to the start position, percentage maximal voluntary isometric contraction (%MVIC) values of the VM, TA and GM demonstrated a significantly higher activities in the end position(p<.05). Conclusion : The result shows that contralateral leg muscles activities significantly more increase in the end position when PNF lifting was applied. Therefore, this study will be used to prove effect of indirect approach for the stability and strengthening in patients with leg impairments.

• Archives of Craniofacial Surgery
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• v.11 no.1
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• pp.45-48
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• 2010

Purpose: After surgical interventions of mandible fractures, facial asymmetry can be occurred, and it leads to serious problems for patients. This can be solved by mandible angle ostectomy. Methods: A 19-year-old male underwent percutaneous surgical intervention for left mandibular angle and right parasymphyseal fractures 3.5 years ago. The left angle was protruded compared to the other side. Using a percutaneous approach, $4.5{\times}1cm$ sized piece of mandible angle was sawed off. For the right angle, intraoral approach was performed for angle ostectomy, and the angle was sawed off by a size of $4{\times}1cm$, using a pattern based on the piece from the left side. Results: After surgery, no complications such as subcondylar fractures, refractures, insufficient corrections, secondary angle formations, hematomas, and transient nerve palsies were seen, and symmetric correction of mandible angles were done. Conclusion: In facial asymmetries due to mandibular fractures, mandible ostectomy could be a solution. Using the bone section from the contralateral side, measurement of the amount of bone sawed off was possible, and via percutaneous approach on the previously operated site with simultaneous scar revision, and intraoral approach for the contralateral side, cosmetically satisfactory result was obtained.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.20 no.4
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• pp.235-240
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• 2018

The safety and feasibility of simple coil embolization and stent deployment for the treatment of posterior inferior cerebellar artery (PICA) aneurysms, as well as their radiologic and clinical results, have not been adequately understood. Especially, if dissecting aneurysm of proximal PICA is associated with small caliber PICA and stenosis of ipsilateral vertebral artery orifice (VAO), endovascular coiling with saving of PICA is not always easy. This 64-year-old man presented with subarachnoid hemorrhage due to a ruptured dissecting aneurysm of left proximal PICA. The aneurysm was irregularly fusiform in nature with a shallow PICA orifice (1.4 mm) and narrow caliber (0.9-1.5 mm). Moreover, the ipsilateral VAO showed severe stenosis (1.8 mm). We performed bifemoral puncture and chose additional route from right vertebral artery to left vertebrobasilar junction for retrograde approach and deployment of LVIS Jr. intraluminal support at proximal PICA. And then, the antegrade approach and coiling of aneurysm was done. Despite of transient thrombus of PICA, the aneurysm was successfully secured with preservation of whole PICA course. For preservation of narrow PICA with ipsilateral VAO stenosis, the contralateral approach and deployment of LVIS Jr. intraluminal support may be considered.

• Korean Journal of Head & Neck Oncology
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• v.32 no.1
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• pp.41-44
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• 2016

The resection of submandibular gland is usually performed via trascervical, transoral approach. The authors suspected the stenosis of Wharton's duct of 54 years old female patient after transoral removal of submandibular stone and the resection of submandibular gland was decided. Because of cosmetic need, the resection was performed transorally. The operation was completed successfully without any injury to unilateral lingual nerve or hypoglossal nerve but contralateral paralysis of hypoglossal nerve was seen. In our knowledge, this is the first report of contralateral hypoglossal nerve palsy during transoral resection of submandibular gland.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.535-541
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• 2014

Background Patients having unilateral breast reconstruction often require a second stage procedure on the contralateral breast to improve symmetry. In order to provide immediate symmetry and minimize the frequency and extent of secondary procedures, we began performing simultaneous contralateral balancing operations at the time of initial reconstruction. This study examines the indications, safety, and efficacy of this approach. Methods One-hundred and two consecutive breast reconstructions with simultaneous contralateral balancing procedures were identified. Data included patient age, body mass index (BMI), type of reconstruction and balancing procedure, specimen weight, transfusion requirement, complications and additional surgery under anesthesia. Unpaired t-tests were used to compare BMI, specimen weight and need for non-autologous transfusion. Results Average patient age was 48 years. The majority had autologous tissue-only reconstructions (94%) and the rest prosthesis-based reconstructions (6%). Balancing procedures included reduction mammoplasty (50%), mastopexy (49%), and augmentation mammoplasty (1%). Average BMI was 27 and average reduction specimen was 340 grams. Non-autologous blood transfusion rate was 9%. There was no relationship between BMI or reduction specimen weight and need for transfusion. We performed secondary surgery in 24% of the autologous group and 100% of the prosthesis group. Revision rate for symmetry was 13% in the autologous group and 17% in the prosthesis group. Conclusions Performing balancing at the time of breast reconstruction is safe and most effective in autologous reconstructions, where 87% did not require a second operation for symmetry.