• Annals of Clinical Neurophysiology
• /
• v.7 no.1
• /
• pp.31-33
• /
• 2005

Segmental zoster paresis (SZP) is a clinically rare complication of herpes zoster. But it has not been reported that acute cerebral motor cortical infarction coincidentally occurred in SZP. A 86-year-old woman was admitted due to pain, tingling sensation, and weakness of left arm. She had an acute onset of pain and tingling sensation in left arm at first day, shoulder weakness at second day, and multifocal vesicles at fourth day. Deep tendon reflexes of left arm were decreased than right. Electromyography showed an axonal polyneuropathy at superior trunk level of left brachial plexus. Median and ulnar sensory evoked potential tests were normal. Brain MRI showed a high signal in right primary motor cortex on diffusion weighted image. We report a case of acute cerebral motor cortical infarction coincidentally occurred in SZP.

• Journal of Korean Neurosurgical Society
• /
• v.41 no.3
• /
• pp.182-185
• /
• 2007

Acute stroke with isolated monoparesis manifesting as distal weakness of a single lower extremity has rarely been described. We report two patients with small cortical infarction who had distal weakness of a single lower extremity. In both cases, diffusion-weighted image [DWI] was used to detect small lesions in the contralateral cortex. These cases illustrate that small cortical infarction can cause isolated monoparesis limited to distal part of the leg and it may be misdiagnosed as spinal lesions, especially when lower back pain and transient sensory symptoms are accompanied. In case of the abrupt onset of weakness limited to one lower limb, the possibility of stroke should be considered and careful attention to identify cortical lesions using magnetic resonance imaging, especially DWI is required.

• The Journal of Internal Korean Medicine
• /
• v.22 no.2
• /
• pp.263-269
• /
• 2001

Monoplegia is the paralysis of either the upper or lower limb. Monoplegia is commonly caused by an injury to the cerebral cortex; it is rarely caused by an injury to the internal capsule, brain stem, or spinal cord. Most cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. According to motor homunculus, lower limb monoplegia occurs from limited damage to the most upper part of the primary motor area(Brodmann's area 4, located in precentral gyrus). Clinically, lower limb monoplegia due to brain cortical infarction is commonly misunderstood as monoplegia due to spinal injury because the lesion is situated at the most upper part of precentral gyrus. We had many difficulties in finding lesion on brain CT, but we diagnosed two patients correctly by using an MRI, who have lower limb monoplegia due to brain cortical infarction oriental treatment.

• Investigative Magnetic Resonance Imaging
• /
• v.17 no.4
• /
• pp.312-315
• /
• 2013

When cerebral cortical hyperintensities on diffusion-weighted image are seen in patients with suspected acute stroke accompanying seizure, it is necessary to differentiate whether they are caused by infarction or seizure-related change. We report a case of seizure-related cortical hypertensities in a patient with suspected acute infarction. With perfusion MR imaging, we could differentiate from acute infarction.

• The Journal of Korean Medicine
• /
• v.18 no.1
• /
• pp.337-343
• /
• 1997

With the purpose of producing easily the basal ganglia infarction into Chen's, scerebral ischemic model which is almost cortical infarct made by the ligation of distal part of MCA and 1 hr obliteration of both common carotid arteries in rat, the MCA obstruction was extended between rhinal fissure and olfactory tract with electrocauterization in place of 10-0 silk suture ligation of distal part of MCA. Both original Chen's model and modified Chen's have shown the cortical infarction in dorsolateral & lateral frontoparietal cortex, but not any infarction in basal ganglia. However, the modified Chen's model have shown the effect of average 12% increase in cortical infarct than that of original Chen's model. This experimental results suggest the modified Chen's model can not reduce the blood flow of the lateral lenticulostriatal artery enough to make the basal ganglia infarction and that blood circulation of basal gagglia under its condition is probably being kept partly through the posterior cerebral artery via vertebral artery. Therefore, The follow-up observation on ischemic time lapse would be needed.

• Annals of Clinical Neurophysiology
• /
• v.7 no.1
• /
• pp.20-21
• /
• 2005

Myoclonus may originate from the cerebral cortex, subcortical structures, brainstem, spinal cord or peripheral nerve. But unilateral upper limb myoclonus related to cortical infarct is an unusual clinical picture. We report a 67-year-old man presented with myoclonus, associated with primary motor cortex infarction.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.5
• /
• pp.419-422
• /
• 2014

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by sudden-onset headache with focal neurologic deficit and prolonged but reversible multifocal narrowing of the distal cerebral arteries. Stroke, either hemorrhagic or ischemic, is a relatively frequent presentation in RCVS, but progressive manifestations of subarachnoid hemorrhage, intracerebral hemorrhage, cerebral infarction in a patient is seldom described. We report a rare case of a 56-year-old woman with reversible cerebral vasoconstriction syndrome consecutively presenting as cortical subarachnoid hemorrhage, intracerebral hemorrhage, and cerebral infarction. When she complained of severe headache with subtle cortical subarachnoid hemorrhage, her angiography was non-specific. But, computed tomographic angiography showed typical angiographic features of this syndrome after four days. Day 12, she suffered mental deterioration and hemiplegia due to contralateral intracerebral hematoma, and she was surgically treated. For recurrent attacks of headache, medical management with calcium channel blockers has been instituted. Normalized angiographic features were documented after 8 weeks. Reversible cerebral vasoconstriction syndrome should be considered as differential diagnosis of non-aneurysmal subarachnoid hemorrhage, and repeated angiography is recommended for the diagnosis of this under-recognized syndrome.

• Journal of Korean Neurosurgical Society
• /
• v.48 no.4
• /
• pp.357-359
• /
• 2010

While a delayed intracerebral hemorrhage at the site of a ventricular catheter has occasionally been reported in literature, a delayed hemorrhage caused by venous infarction secondary to ventriculoperitoneal shunting has not been previously reported. In the present case, a 68-year-old woman underwent ventriculoperitoneal shunting through a frontal burr hole, and developed a hemorrhagic transformation of venous infarction on the second postoperative day. This massive venous infarction was caused by bipolar coagulation and occlusion of a large paramedian cortical vein in association with atresia of the rostral superior sagittal sinus. Thus, to eliminate the risk of postoperative venous infarction, technical precautions to avoid damaging surface vessels in a burr hole are required under loupe magnification in ventriculoperitoneal shunting.

• Investigative Magnetic Resonance Imaging
• /
• v.18 no.4
• /
• pp.362-365
• /
• 2014

Predominant involvement of a particular group of fingers due to a central nervous system lesion has been described as pseudoperipheral palsy. Two patients visited our hospital with isolated weakness of a particular group of fingers due to small cortical infarctions. A 51-year-old woman suddenly developed weakness in her left index and middle fingers. The brain MRI showed a small infarct in the right frontal cortex. A 67-year-old man was sudden difficulty using his chopsticks and had weakness in his right thumb and index finger. The brain MRI showed a small infarct in the left precentral cortex.

• Journal of Chest Surgery
• /
• v.18 no.4
• /
• pp.746-752
• /
• 1985

A retrospective clinical observation was made of 40 patients with postoperative cerebral dysfunction among 2634 patients who underwent open-heart operations in Severance Hospital. Yonsei University between 1962, the year the first successful open heart operation was done, and June 1985. Suspected causes of brain damage were reviewed. Brain CT findings were evaluated in 24 patients. There were 15 cerebral infarcts, 4 intracerebral bleedings, 3 ischemic brain damages, 1 infarction with intracerebral hemorrhage and 1 diffuse cortical atrophy from unknown cause. The most frequent site of cerebral infarction was the middle cerebral artery area with no predilection on the right of left.