• 대한의생명과학회지
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• 제15권1호
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• pp.17-23
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• 2009

The prevalence of patent foramen ovale (PFO) in healthy persons was estimated as about $10{\sim}25%$ and was up to 40% in patients with stroke. Transesophageal echocardiography (TEE) was considered to be the most sensitive method to detect PFO and was used as the gold standard. Transcranial doppler sonography (TCD) of the middle cerebral artery (MCA) during a contrast (saline bubble) injection has recently been proposed as an alternative detecting method for PFO. In this study, we would like to know the difference between TCD value and TEE value in subjects with cryptogenic ischemic stroke. We performed TCD and TEE tests to detect PFO on 64 patients (30 women and 34 men, mean age was 59.4 years) with cryptogenic ischemic stroke. PFO prevalence through TCD was 45.3% (29 of 64 patients) and the prevalence through TEE was 34.4% (22 of 64 patients). There was no statistical significance between PFO test and TCD test (P=0.206). But TCD had a sensitivity of 90.9% (20 of 22 patients), specificity of 78.6% (33 of 42 patients), positive predictive value of 69.0% (20 of 29 patients), and negative predictive value of 94.3% (33 of 35 patients). We concluded that TCD was a highly sensitive method for detecting a right-left shunt. Therefore, the non-invasive TCD test is a method more effective than the anti-invasive TEE test in the cost and evaluation of the existence or nonexistence of right to left shunt in addition to the screening method of the cerebrovascular disorder. Considering these points, TCD test could be recommended for patients with cryptogenic ischemic stroke as a useful and convenient method for screening of the existence or nonexistence of a right to left shunt caused by PFO.

• 대한임상검사과학회지
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• 제52권1호
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• pp.78-82
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• 2020

경동맥갈퀴막은 전체 뇌졸중 환자에서 매우 드물게 발견되는 희귀한 질환이며, 원인불명뇌졸중(cryptogenic stroke) 환자에서 다른 뇌졸중 아형에 비해 빈번하게 관찰되는 특징이 있다. 혈관 내막의 섬유근이형성증(fibromuscular dysplasia)이 경동맥갈퀴막의 원인으로 알려져 있고, 경동맥갈퀴막은 혈관 내 혈류의 교란을 야기하여 혈전을 만들고 색전성 뇌졸중을 일으킬 수 있다고 보고되었다. 경동맥갈퀴막은 섬유근이형성증으로 인해 비교적 딱딱한 섬유성 구조물이 혈관의 내강으로 뻗어 나오게 되고, 이중초음파에서 이중 속공간(double lumen)을 만들기 때문에 경동맥박리와 혼동하기 쉽다. 또한, 경동맥갈퀴막은 갈퀴막(web) 모양이기 때문에 궤양성죽상판과 같은 다른 경동맥질환과 혼동할 우려가 있다. 하지만, 경동맥갈퀴막은 시작 부위가 굵었다가 끝으로 갈수록 가늘어지는 경향이 있고, 박동성 혈류에 의한 펄럭임이 없는 것이 특징이다. 따라서, 본 연구는 총 4개의 경동맥갈퀴막 증례를 가지고, 질환에 대한 전반적인 설명과 함께 이중초음파의 특징적인 소견에 집중하여 보고하고자 한다.

• 대한임상독성학회지
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• 제18권1호
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• pp.47-50
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• 2020

A 21-year-old female patient complaining of hemiparesis was diagnosed with right middle cerebral artery infarction. No risk factor was found, despite an extensive young-age stroke work-up, except her history of marijuana use. The patient had smoked marijuana for treating depression for more than five years. Magnetic resonance angiography showed multifocal intra- and extracranial stenoses, suggesting cannabinoid-induced vasculopathy. Since the use of illicit drugs has increased nationwide, physicians should consider it as a possible cause of a stroke due to an unknown etiology.