• 제목/요약/키워드: Intracerebral

검색결과 315건 처리시간 0.024초

좌측 편마비 및 보행장애를 주소로 한 뇌내출혈 환자에 대한 한방 복합 치료 증례보고 1례 (A Case Report of Combined Korean Medicine Treatment for a Intracerebral Hemorrhage Patient with Hemiplegia and Gait Disturbance)

  • 양지혜;채인철;최인우;김찬영;유주영;유호룡;김윤식;설인찬
    • 혜화의학회지
    • /
    • 제29권2호
    • /
    • pp.1-11
    • /
    • 2020
  • Objectives : The aim of this study was to report the effectiveness of Combined Korean Medicine treatment on a intracerebral hemorrhage patient with hemiplegia and gait disturbance. Methods : A 56-year-old, female patient with hemiplegia and gait disturbance was treated by Korean Medicine including acupuncture, moxibustion and herbal medicine. The effect of the treatment was evaluated by Manual Muscle Test(MMT), Modified Rankin Scale(MRS), Korean version of Modified Barthel Index(K-MBI). The gait of the patient was evaluated by 10m walk test, Timed Up&Go Test(TUG), Functional Ambulatory Category(FAC), GAITRite and Symmetry Criterion(SC). Results : After treatment, MMT, MRS, K-MBI, gait parameters and gait symmetry were improved. Conclusions : This study suggests that Combined Korean Medicine treatment might be effective for a intracerebral hemorrhage patient with hemiplegia and gait disturbance.

뇌내출혈 이후 발생한 혈관성 치매 환자에 대한 귀비탕가미방 치험 1례 (A Case Report of a Patient with Vascular Dementia Caused by Intracerebral Hemorrhage Treated with Modified Guibi-tang)

  • 윤혜수;이은창;손정민;권선우;박충현;권이재;이효정;이정은
    • 대한한방내과학회지
    • /
    • 제44권5호
    • /
    • pp.1033-1040
    • /
    • 2023
  • Objectives: The aim of this study is to describe the effects of traditional Korean medicine treatment on a patient with vascular dementia caused by an intracerebral hemorrhage. Methods: The patient was treated with herbal medicine (modified Guibi-tang) and acupuncture. The effects of these treatments were evaluated using the Korean Mini Mental Status Examination (K-MMSE-2), Cognitive Dementia Rating (CDR), Manual Muscle Test (MMT), Korean version of Modified Barthel Index (K-MBI), and Videofluoroscopic Swallow Study (VFSS). Results: After treatment, the K-MMSE-2 score, CDR score, MMT, K-MBI, and VFSS improved. Conclusion: The results suggest that traditional Korean medicine may be effective for the symptoms of vascular dementia caused by intracerebral hemorrhage.

상지 구획 증후군 이후 발생한 치명적인 뇌출혈 (A Fatal Intracerebral Hemorrhage Complicated by Compartment Syndrome of the Upper Arm)

  • 한인보;정영선;신동은;허륭;정상섭;안정용
    • Journal of Trauma and Injury
    • /
    • 제19권2호
    • /
    • pp.178-182
    • /
    • 2006
  • Compartment syndrome has a wide spectrum from muscle pain to a life- threatening condition, such as acute renal failure and disseminated intravascular coagulation (DIC). Intracerebral hemorrhage (ICH) due to compartment syndrome has not been reported. We report a patient who presented with ICH leading to death. A 25-year-old female with no significant past history developed extensive compartment syndrome followed by rhabdomyolysis, acute renal failure, DIC, and ICH. Although the patient underwent a fasciotomy and hemodialysis and received aggressive resuscitation with massive transfusions of blood and intravenous fluids, she died. This case stresses the importance of early diagnosis and prompt treatment of compartment syndrome to prevent devastating complications.

뇌출혈을 동반한 만성골수성백혈병 환자 1례에 대한 임상적 고찰 (A Case of Chronic Myeloblastic Leukemia with Intracerebral Hemorrhage)

  • 이영수;최창원;이강녕;김희철;곽정진
    • 대한한방내과학회지
    • /
    • 제23권2호
    • /
    • pp.260-267
    • /
    • 2002
  • Chronic Myeloblastic Leukemia(CML) is characterised by excessive production of neoplastic myeloid cell, reciprocal translocation between chromosome 9 and 22 called 'Philadelphia chromosome'. This one case of CML with Intracerebral Hemorrhage(ICH) patient is thought of Kidney-Yin and Yang deficiency, by the first clinical symptoms, at admission. So the nourishing Yin and Tonifying kidney, warming and tonifying kidney-yang is used. After the incresing of WBC count, the nourishing Yin and Tonifying kidney, invigorating-Yin and reducing fire is used for treatment of the essence-of-life and blood deficiency, fever due to Yin deficiency.

  • PDF

Impact of Early Enteral Nutrition on In-Hospital Mortality in Patients with Hypertensive Intracerebral Hemorrhage

  • Lee, Jeong-Shik;Jwa, Cheol-Su;Yi, Hyeong-Joong;Chun, Hyoung-Joon
    • Journal of Korean Neurosurgical Society
    • /
    • 제48권2호
    • /
    • pp.99-104
    • /
    • 2010
  • Objective : We conducted this study to evaluate the clinical impact of early enteral nutrition (EN) on in-hospital mortality and outcome in patients with critical hypertensive intracerebral hemorrhage (ICH). Methods : We retrospectively analyzed 123 ICH patients with Glasgow Coma Scale (GCS) score of 3-12. We divided the subjects into two groups : early EN group (< 48 hours, n = 89) and delayed EN group ($\geq$ 48 hours, n = 34). Body weight, total intake and output, serum albumin, Creactive protein, infectious complications, morbidity at discharge and in-hospital mortality were compared with statistical analysis. Results : The incidence of nosocomial pneumonia and length of intensive care unit stay were significantly lower in the early EN group than in the delayed EN group (p < 0.05). In-hospital mortality was less in the early EN group than in the delayed EN group (10.1% vs. 35.3%, respectively; p = 0.001). By multivariate analysis, early EN [odds ratio (OR) 0.229, 95% CI : 0.066-0.793], nosocomial pneumonia (OR = 5.381, 95% CI : 1.621-17.865) and initial GCS score (OR = 1.482 95% CI : 1.160-1.893) were independent predictors of in-hospital mortality in patients with critical hypertensive ICH. Conclusion : These findings indicate that early EN is an important predictor of outcome in patients with critical hypertensive ICH.

A Long-Term Survival Case of a Primary Malignant Intracerebral Nerve Sheath Tumor

  • Lee, Byung Sun;Kim, Young Gyu;Kim, Dong Ho;Lee, Mou Seop
    • Journal of Korean Neurosurgical Society
    • /
    • 제54권3호
    • /
    • pp.261-264
    • /
    • 2013
  • We report a long-term survival case of a primary malignant intracerebral nerve sheath tumor (MINST) occurring in the right frontal lobe of a 13-year old boy. After the gross total resection (GTR), we have performed radiation therapy but it recurred 50 months after the surgery, so the second GTR was performed. Later, second tumor recurrence was found 4 months after the second surgery. Subsequently the third GTR, radiotherapy, and chemotherapy were carried out. At present, the patient has been remaining alive for 77 months without evidence of tumor recurrence. According to the previous reports, the primary MINST is very rare : there are only 8 cases reported. It is also a fast-growing, invasive tumor with poor outcome. This is the first case that had no recurrence for 50 months after the surgery among the reported cases that had been followed up for more than 5 years. It is supposed that a period of recurrence free survival after GTR and low mitotic activity are associated with the patient's prognosis. A GTR followed by adjuvant radiation therapy and chemotherapy will be recommended to patients of MINST.

Emergent Clipping without Prophylactic Decompressive Craniectomy in Patients with a Large Aneurysmal Intracerebral Hematoma

  • Kang, Sung-Don
    • Journal of Korean Neurosurgical Society
    • /
    • 제44권6호
    • /
    • pp.353-357
    • /
    • 2008
  • Objective : Many vascular neurosurgeons tend to remove bone flap in patients with large aneurysmal intracerebral hematomas (ICH). However, relatively little work has been done regarding the effectiveness of prophylactic decompressive craniectomy in a patient with a large aneurysmal ICH. Methods : Large ICH was defined as hematoma when its volume exceeded 25 mL, ipsilateral to aneurysms. The patients were divided into two groups; aneurysmal subarachnoid hemorrhage (SAH) associated with large ICH, January, 1994 - December, 1999 (Group A, 41 patients), aneurysmal SAH associated with large ICH, January, 2000 - May, 2005 (Group 8, 27 patients). Demographic and clinical variables including age, sex, hypertension, vasospasm, rebleeding, Hunt-Hess grade, aneurysm location, aneurysm size, and outcome were compared between two groups, and also compared between craniotomy and craniectomy patients in Group A. Results : In Group A. 21 of 41 patients underwent prophylactic decompressive craniectomy. In Group 8, only two patients underwent craniectomy. Surgical outcome in Group A (good 23, poor 18) was statistically not different from Group 8 (good 15, poor 12). Surgical outcomes between craniectomy (good 12, poor 9) and craniotomy cases (good 11, poor 9) in Group A were also comparable. Conclusion : We recommend that a craniotomy can be carried out safely without prophylactic craniectomy in patients with a large aneurysmal ICH if intracranial pressure is controllable with hematoma evacuation.

Prior Use of 3-Hydroxy-3-Methyl-Glutaryl-Coenzyme A Reductase Inhibitor, Simvastatin Fails to Improve Outcome after Experimental Intracerebral Hemorrhage

  • Jwa, Cheol-Su;Yi, Hyeong-Joong;Oh, Suck-Jun;Hwang, Se-Jin
    • Journal of Korean Neurosurgical Society
    • /
    • 제50권5호
    • /
    • pp.403-408
    • /
    • 2011
  • Objective : Contrary to some clinical belief, there were quite a few studies regarding animal models of intracerebral hemorrhage (ICH) $in$ $vivo$ suggesting that prior use of statins may improve outcome after ICH. This study reports the effect of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG CoA) reductase inhibitor, simvastatin given before experimental ICH. Methods : Fifty-one rats were subjected to collagenase-induced ICH, subdivided in 3 groups according to simvastatin treatment modality, and behavioral tests were done. Hematoma volume, brain water content and hemispheric atrophy were analyzed. Immunohistochemical staining for microglia (OX-42) and endothelial nitric oxide synthase (eNOS) was performed and caspase-3 activity was also measured. Results : Pre-simvastatin therapy decreased inflammatory reaction and perihematomal cell death, but resulted in no significant reduction of brain edema and no eNOS expression in the perihematomal region. Finally, prior use of simvastatin showed less significant improvement of neurological outcome after experimental ICH when compared to post-simvastatin therapy. Conclusion : The present study suggests that statins therapy after ICH improves neurological outcome, but prior use of statins before ICH might provide only histological improvement, providing no significant impact on neurological outcome against ICH.

The Spot Sign Predicts Hematoma Expansion, Outcome, and Mortality in Patients with Primary Intracerebral Hemorrhage

  • Han, Ju-Hee;Lee, Jong-Myong;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
    • /
    • 제56권4호
    • /
    • pp.303-309
    • /
    • 2014
  • Objective : The purpose of this study was to retrospectively review cases of intracerebral hemorrhage (ICH) medically treated at our institution to determine if the CT angiography (CTA) 'spot sign' predicts in-hospital mortality and clinical outcome at 3 months in patients with spontaneous ICH. Methods : We conducted a retrospective review of all consecutive patients who were admitted to the department of neurosurgery. Clinical data of patients with ICH were collected by 2 neurosurgeons blinded to the radiological data and at the 90-day follow-up. Results : Multivariate logistic regression analysis identified predictors of poor outcome; we found that hematoma location, spot sign, and intraventricular hemorrhage were independent predictors of poor outcome. In-hospital mortality was 57.4% (35 of 61) in the CTA spot-sign positive group versus 7.9% (10 of 126) in the CTA spot-sign negative group. In multivariate logistic analysis, we found that presence of spot sign and presence of volume expansion were independent predictors for the in-hospital mortality of ICH. Conclusion : The spot sign is a strong independent predictor of hematoma expansion, mortality, and poor clinical outcome in primary ICH. In this study, we emphasized the importance of hematoma expansion as a therapeutic target in both clinical practice and research.

Glioma Mimicking a Hypertensive Intracerebral Hemorrhage

  • Choi, Go;Park, Dong-Hyuk;Kang, Shin-Hyuk;Chung, Yong-Gu
    • Journal of Korean Neurosurgical Society
    • /
    • 제54권2호
    • /
    • pp.125-127
    • /
    • 2013
  • Here, we report a rare case of an anaplastic astrocytoma masquerading as a hypertensive basal ganglia hemorrhage. A 69-year-old woman who had been under medical management for hypertension during the past 3 years suddenly developed right hemiparesis with dysarthria. Brain computed tomography (CT) scans with contrast and CT angiograms revealed an intracerebral hemorrhage (ICH) in the left basal ganglia, without an underlying lesion. She was treated conservatively, but underwent a ventriculoperitoneal shunt operation 3 months after the initial attack due to deteriorated mental status and chronic hydrocephalus. Three months later, her mental status deteriorated further. Magnetic resonance imaging (MRI) with gadolinium demonstrated an irregular enhanced mass in which the previous hemorrhage occurred. The final histological diagnosis which made by stereotactic biopsy was an anaplastic astrocytoma. In the present case, the diagnosis of a high grade glioma was delayed due to tumor bleeding mimicking hypertensive ICH. Thus, a careful review of neuroradiological images including MRI with a suspicion of tumor bleeding is needed even in the patients with past medical history of hypertension.