• Title/Summary/Keyword: Middle Cerebral Artery Infarction

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The Effect of Visual Cue Deprivation for the Head Alignment on Unilateral Neglect Patient: Case Report (편측 무시 환자에서 시각 정보 차단이 머리 위치 정렬에 미치는 영향: 사례 연구)

  • Chang, Jong-Sung;Park, Jung-Mi;Lee, Mi-Young
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.3
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    • pp.337-342
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    • 2013
  • PURPOSE: The Unilateral neglect is characterized by difficulty shifting attention to the side of space opposite the brain lesion and frequently reducing use of contralesional extremities. This study was to identify whether the visual deprivation was responsible for head position on unilateral neglect patient after stroke. METHODS: A patient with left middle cerebral artery infarction participated in the study. We assessed neglect using line bisection and star cancellation test. Patient was instructed to maintain correct alignment of trunk and head in a sit position. We evaluated degree of head lateral tilting and rotation. Then, patient was blocked visual input. Also, we evaluated head position in the same way. RESULTS: He scored 3 points in the line bisection test and 9 points star cancellation test. In postural evaluation, he had deviated posture such as lateral head tilting and rotation. After visual cue deprivation, patient showed different head position which was decreased degree of head tilting and rotation. CONCLUSION: For vertical body orientation, it was used multiple sensory references including the vestibular, somatosensory, and visual system. This finding suggested that abnormal posture of neglect patient could be related to the visual input. It has important clinical implications in terms of understanding the neglect.

A Case Report on an Elderly Patient with Acute Hematochezia and Anemia Improved by Treatment with Korean Medicine (한의약 치료를 통해 급성 혈변 및 빈혈이 개선된 노인 환자 1례에 대한 증례 보고)

  • Chu, Hongmin;Lee, Young-ung;Kim, Kwang-ho;Kim, Cheol-hyun;Lee, Sang-kwan;Sun, Kang-keyng
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1259-1267
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    • 2019
  • Introduction: The aim of this study was to report the effect of Korean medicine treatments on an elderly patient with acute hematochezia and anemia Case presentation: An 81-year-old female with chronic multifocal middle cerebral artery infarction had symptoms of acute hematochezia and anemia. Method: The patient was treated with Korean medicine therapy. Results: Treatment with Korean medicine, including herbal medicine, significantly improved the patient's symptoms. After treatment, her hematochezia was improved and the results of a complete blood count (CBC) also improved. No side effects were observed during treatment. Conclusion: Korean medicine treatment can be considered an effective treatment for acute hematochezia and anemia in an elderly patient.

Neurotrophic Actions of Ginsenoside Rbi, Peptide Growth Factors and Cytokines

  • Masahiro Sakanaka;Wen, Tong-Chun;Kohji Sato;Zhang, Bo
    • Proceedings of the Ginseng society Conference
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    • 1998.06a
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    • pp.21-30
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    • 1998
  • Ginseng root has been considered to prevent neuronal degeneration associated with brain ischemia, but experimental proof in support of this speculation is limited. Moreover, few studies have compared the neuroprotective actions of ginseng ingredients with those of peptide growth factors and cytokines isf vivo. Using a gerbil forebrain ischemia model, we demonstrated that the oral administration of red ginseng powder before an ischemic insult prevents delayed neuronal death in the hippocampal CAI field and that a neuroprotective molecule within red ginseng powder is ginsenoside Rbl. The neurotrophic effect of ginsenoside Rbl, when examined in the gerbil ischemia model and in neuronal cultures was as potent as or more potent than the effects of epidermal growth factor, ciliary neurotrophic factor, erythropoietin, prosaposin, interleukin-6 and interleukin-3. Besides the protection of hippocampal CAI neurons against brain ischemia/repercussion injuries, ginsenoside Rbl was shown to prevent place navigation disability, cortical infarction and secondary thalamic degeneration in stroke-prone spontaneous hypertensive rats with permanent occlusion of the unilateral middle cerebral artery distal to the striate branches. These findings may validate the empirical use of ginseng root for the treatment of cerebrovascular diseases

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Involvement of Cortical Damage in the Ischemia/Reperfusion-Induced Memory Impairment of Wistar Rats

  • Hong, Jin-Tae;Ryu, Seung-Rel;Kim, Hye-Jin;Lee, Sun-Hee;Lee, Byung-Moo;Kim, Pu-Young
    • Archives of Pharmacal Research
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    • v.23 no.4
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    • pp.413-417
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    • 2000
  • The effect of ischemia/reperfusion-induced neuronal damage on the memory impairment were investigated using active avoidance and Morris water maze tasks in Wistar rats. Focal ischemia was induced by 1 h occlusion of the right middle cerebral artery (MCA) of Wistar male rats. Reperfusion was induced by releasing the occlusion and restoring the blood circulation for 24 h. The acquisition and preservation memory tested by active avoidance showed a significant difference between the sham and ischemia/reperfusion group. The water maze acquisition performance was also significant difference between sham and ischemia/repefusion groups in both latency and moving distance. The infarction volume was increased by the ischemia/reperfusion. Furthermore, the cresyl violet staining of the ischemia/reperfusion brain showed severe neuronal damage (pyramidal cell loss) in the cortex in addition to the striatum lesion of brain. This study shows that pyramidal cell damage in the cortex lesion may be partially related to memorial disturbance in the ischemia/reperfusion brain injury.

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The Effectiveness of Combination Therapy of Oriental Medicine and Western Medicine on Acute Stroke: a controlled study (급성기 뇌졸중에 대한 한양방 병용치료의 효과)

  • Park, Jung-Mi;Choi, Byung-Ok;Jung, Woo-Sang
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.393-396
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    • 2001
  • Objectives: We were to assess the effectiveness of combined therapy of Oriental Medicine and Western Medicine on acute stroke. Methods: We selected acute middle cerebral artery territory infarction subjects, within 3 days after stroke onset, who had never have any type of stroke history before. The subjects, admitted to department of Oriental Medicine, received combination therapy of western medical treatment including thrombolytic, anticoagulant, or antiplatelet agents and oriental medical treatment including acupuncture and herbs medication. The other subjects, admitted to department of Neurology, received only modern western medical treatment. The National Institute of Health Stroke Scale (NIHSS) was checked at admission, 1 week and 2 weeks later to assess neurologic improvement. The Modified Barthel Index (MBI) was checked 1 week and 2 weeks after admission to motor function recovery. Results: Comparing the NIHSS between baseline and 1 week later, the combination therapy group showed more improvement than the single-treated with anticoagulants group. However, there was no significant difference between the two groups, comparing 1 week and 2 weeks later with the NIHSS and the MBI. Conclusions: Combination therapy have more beneficial effect on acute stage of stroke.

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The Effects of Superior Cervical Sympathetic Ganglion Block on the Acute Phase Injury and Long Term Protection against Focal Cerebral Ischemia/Reperfusion Injury in Rats (백서의 국소 뇌허혈/재관류로 인한 신경손상에서 상경부 교감 신경절 블록의 급성기 및 장기 보호효과)

  • Jeon, Hae Young;Joung, Kyoung Woon;Choi, Jae Moon;Kim, Yoo Kyung;Shin, Jin Woo;Leem, Jeong Gill;Han, Sung Min
    • The Korean Journal of Pain
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    • v.21 no.2
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    • pp.119-125
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    • 2008
  • Background: Cerebral blood vessels are innervated by sympathetic nerves from the superior cervical ganglia (SCG), and these nerves may influence the cerebral blood flow. The purpose of the present study was to evaluate the neuroprotective effect of superior cervical sympathetic ganglion block in rats that were subjected to focal cerebral ischemia/reperfusion injury. Methods: Eighty male Sprague-Dawley rats (270-320 g) were randomly assigned to one of two groups (the ropivacaine group and a control group). In all the animals, brain injury was induced by middle cerebral artery (MCA) reperfusion that followed MCA occlusion for 2 hours. The animals of the ropivacaine group received $30{\mu}l$ of 0.75% ropivacaine, and their SCG. Neurologic score was assessed at 1, 3, 7 and 14 days after brain injury. Brain tissue samples were then collected. The infarct ratio was measured by 2.3.5-triphenyltetrazolium chloride staining. The terminal deoxynucleotidyl transferase mediated dUTP-biotin nick-end labeled (TUNEL) reactive cells and the cells showing caspase-3 activity were counted as markers of apoptosis at the caudoputamen and frontoparietal cortex. Results: The death rate, the neurologic score and the infarction ratio were significantly less in the ropivacaine group 24 hr after ischemia/reperfusion injury. The number of TUNEL positive cells in the ropivacaine group was significantly lower than those values of the control group in the frontoparietal cortex at 3 days after injury, but the caspase-3 activity was higher in the ropivacaine group than that in the control group at 1 day after injury. Conclusions: The study data indicated that a superior cervical sympathetic ganglion block may reduce the neuronal injury caused by focal cerebral ischemia/reperfusion, but it may not prevent the delayed damage.

A Case Report of a Disorientation and Dizziness with Acute Anterior Circulation Region Cerebral Infraction Improved by Korean Medical Treatment: Focusing on Sunghyuangjunggi-san-gamibang (Xingxiang zhengqi san) (성향정기산가미방을 중심으로 한 한의약 치료를 통해 단기간에 호전을 보인 전순환계 뇌경색 후 발생한 지남력장애 및 현훈을 주소로 한 환자 1례에 대한 보고)

  • Chu, Hongmin;Kim, Kwang-ho;Lee, Young-ung;Lim, Hyeon-seo;Shin, Hee-Ra;Yang, Mu-hack;Kang, Gun-hui;Park, Chanjong;Kim, Cheol-hyun;Sung, Kang-keyng;Lee, Sang-kwan
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1245-1254
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    • 2020
  • Introduction: The aim of this study was to report the effect of Korean medicine treatments on a stroke patient with acute cerebral infarction. Method: A 63-year-old male with anterior and middle cerebral artery infarction had symptoms of dizziness and disorientation. The patient was treated with Korean medicine therapy, including the herbal medicine "Sunghyuangjunggi-san-gamibang." Treatment progress was assessed using the Korean version of the Modified Barthel Index (K-MBI) and the Korean dizziness handicap inventory (K-DHI). Results: After 14 days of treatment, the K-DHI score decreased from 78 to 7 and the K-MBI score increased from 18 to 24. The patient's main symptoms were improved after the treatment, and no side effects were observed. Conclusion: Korean medicine treatment, including Sunghyuangjunggi-san, might be a recommended therapeutic option for dizziness and disorientation in stroke patients.

Evaluation of Brain Damage Induced by Transient Occlusion of Middle Cerebral Artery in Rats

  • Insook Jung;Lee, Juseon;Melissa D. Oh;Kim, Myungsoo;Changbae Jin
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1997.04a
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    • pp.103-103
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    • 1997
  • 일시적인 국소 뇌허혈 rat model에서 중대뇌동맥의 폐쇄시간에 따른 뇌조직의 손상정도를 비교 조사하였다. 웅성 Wistar rats를 isoflurane 홉입마취하에서 우측 내경동맥내로 17 mm의 silicone-coated 4-0 nylon monofilament를 삽입하여, 중대뇌동맥의 기저부를 30분, 60분 또는 90분동안 폐쇄한 후 이 monofilament를 다시 밖으로 뽑아내므로써 23 시간동안 recirculation 시키는 일시적 국소 뇌허혈 rat model을 사용한 결과, 수술 후 거의 모든 rats에서 left hemiparesis 또는 좌측으로의 circling과 같은 신경학적 결손이 나타나므로써 높은 성공률을 가지고서 비교적 용이하게 뇌허혈을 유발시킬 수 있었으며, 2 mm 두께의 fresh brain coronal slices에 대하여 2,3,5-triphenyltetrazolium chloride (TTC) 염색법을 시행하여 slice surface의 사진을 찍고 computerized 영상분석법을 이용하여 필요한 면적을 측정하므로써, coronal slice의 infarction size (%)는 총 면적에 대한 infarction 면적의 %로서, 부종율 (%)은 대조측 대뇌반구 면적의 2배에 대한 동측 대뇌반구와 대조측 대뇌반구 면적 차이의 %로서 산정되어졌다. 30분 허혈군에서는 본 염색법으로는 infarction이 거의 확인되지 않았으나 60분 허혈군 (n=13)에서는 우측 somatosensory frontoparietal cortex와 striatum 양자 모두 또는 일부 rats에서는 striatum에만 국한된 ulfarction이 확인되어졌으며 90분 허혈군 (n=12)에서는 거의 대부분의 rats에서 위 두 지역 모두에서 infarction이 확인되어졌다. Infarction size (%)는 60분과 90분 허혈군 각각에서, frontal pole로부터 5 mm되는 slice에서는 11.9$\pm$1.2 (평균치$\pm$표준오차), 13.7$\pm$1.9이었으며 7 mm되는 slice에서는 19.1$\pm$1.8, 21.9$\pm$2.1이었으며 9 mm되는 slice에서는 14.7$\pm$2.4, 19.7$\pm$2.2이었다. 또한 부종율 (%)은 60분과 90분 허혈군 각각에서, frontal pole로부터 5 mm되는 slice에서는 3.1$\pm$0.6, 3.8$\pm$0.7이었으며 7 mm되는 slice에서는 3.5$\pm$0.3, 5.7$\pm$1.0이었으며 9 $\pm$되는 slice에서는 3.4$\pm$0.5, 5.7$\pm$0.9이었다. 한편 90분 동안의 중대뇌동맥 폐쇄에 따른 뇌조직 손상을 cresyl violet 염색법, NADPH-diaphorase histochemistry, GFAP immunohistochemistry를 사용하여 일부 측정한 결과, 위의 손상지역에서는 뇌신경세포체들의 shrinkage 내지는 소실됨을 확인할 수 있었으며, NADPH-diaphorase-positive neuron들도 대부분 dendrite와 axon같은 cell process들의 fragmentation, shrinkage 내지는 소실되므로써 intensity의 감소현상이 나타났으며, reactive gliosis로 말미암아 GFAP immunoreactive intensity의 증가현상이 나타났다.

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Effects of Aquatic Exercise on Hind-Limb Muscle and Recovery of Motor Function in the Ischemic Stroke Model of Rats (수중운동이 허혈성 뇌졸중 유발 백서의 하지근육 및 운동기능회복에 미치는 영향)

  • Kim, Gi-Do;Kim, Eun-Jung;Choi, Ki-Bok;Yoo, Young-Dae;Kim, Gye-Yeop
    • The Journal of Korean Physical Therapy
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    • v.18 no.3
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    • pp.59-70
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    • 2006
  • Purpose: This study is intended to examine the aquatic exercise on the improvement of muscle atrophy and motor function in an ischemic stroke model induced by middle cerebral artery occlusion. Methods: We used 60 Sprague-Dawely rats which were divided into 4 groups; the subjects were divided into group of 5 rats. Group I was a group of high dose aquatic exercise after inducing ischemic stroke; Group II was a group of low dose aquatic exercise after inducing ischemic stroke; Group III was a control group, Group IV was a sham group without ischemic stroke. Results: Muscle weight of gastrocnemius muscle was significantly difference in Group II compared to Group III on 8 weeks(p<0.05). For the changes in relative muscle weight of gastrocnemius muscle, there was significant increase in Group II compared to Group III on 8 weeks(p<0.05). For neurologic exercise behavior test, Group II generally had the highest score, compared to other groups. The results of behavior test that Group II improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, indicating a similar state of muscle fiber and brain to Group III. Conclusion: Based on these results, aquatic exercise may improve muscle atrophy and contribute to the improvement of motor function.

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Neuroprotective Effects of Medicinal Herbs in the Transient Focal Ischemia in Rats (일시적 국부 뇌허혈 동물모델에서 한약재의 신경보호 효과)

  • Oh, Jin-Kyung;Jung, Ji-Wook;Ahn, Nam-Yoon;Oh, Hye-Rim;Cheung, Jae-Hoon;Ryu, Jong-Hoon
    • Korean Journal of Pharmacognosy
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    • v.34 no.4 s.135
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    • pp.335-338
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    • 2003
  • It is thought that highly reactive oxygen species generated after strokes plays a key role in damaging the brain. We examined free radical scavenging activity and neuroprotective effects of several medicinal herbs in a rat model of transient ischemia. Free radical scavenging property of medicinal herbs was examined in vitro using 1,1-diphenyl-2-picrylhydrazyl stable free radical. Transient ischemia was induced by intraluminal occlusion of the right middle cerebral artery for 120 min, followed by reperfusion for 22 hr in rats. Aqueous extracts of 8 medicinal herbs (200 mg/kg) were orally administered twice to transient ischemic rat prior to reperfusion and 2 hr after reperfusion. Total infarction volume in the hemisphere ipsilateral to the ischemia-reperfusion was significantly decreased in 7 groups treated with Sophora flavescens, Lycopus lucidus, Sanguisorba officinalis, Caesalpinia sappan, Albizia julibrissin, Rubia akane, Psoralea corylifolia, or Prunella vulgaris. However, neuroprotective effects of these medicinal herbs were not correlated with their antioxidative activities. These results suggest that these medicinal herbs exert neuroprotection via antioxidative as well as unknown mechanism.