• Title/Summary/Keyword: Middle Cerebral Artery Infarction

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A Study on Results of Physical Therapy of Storke Patients (뇌졸중 환자의 물리치료 결과에 관한 연구)

  • Kim, Soo-Min;Joo, Chang-Sik;Kim, Wan-Soo
    • Journal of Korean Physical Therapy Science
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    • v.3 no.1
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    • pp.871-879
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    • 1996
  • The authors studied 74 patients with cal therapy Kosin University Medical March 1994 through February 1995. The results were, as follows: 1. Average age of the subject patients was 59.3 years old, their age ranged from 20 to 84 years old, and the incidence between male and female was 1:1.24 2. In respect to the economy level the middle class revealed the highest incidence, 40(54%) in 74cases. 3. The cause of injury revealed the highest incidence in hypertension 52 patients(72 %), more than all revealed the highest incidence 23 patients(44 %) in 60th years old. 4. The form of injury revealed the highest incidence in infarction 36 patients(49 %), more then all revealed the highest incidence 13 patients (36 %) in 60th years old. 5. As for the region cerebral artery of infarction patients, middle cerebral artery was the highest region of injury 72 %. 6. As for the physical paralysis side, the left side showed higher incidence 40 patients(54 %) compared to the right side 31 patients (42 %). 7. The period of therapy was 56 days, in average extending from 7 days to II months, nore then all there were the most numerous patients within 3 weeks 28 patients(38 %). 8. The upper side of the upper lims had improved 67 patients(91 %), the lower side 48(65 %). In the cases of the lower limb, the upper side had improved 70(95 %), the lower side 58(78 %). In short, patients had improved more the lower limb than the upper limb, the upper side(elbow and shoulder part) then the lower side(wrist and finger) of the upper limb. In the cases of the lower limb, patients had improved more the upper side (knee and hip part) then the lower side(foot and ankle) 9. In the cases of patients can be walking among subject patients 55(74 %) and patients cannot be walking 19 (26 %), In the cases of patients utilized assistant apparatus 34 (62 %) among self-walking, completely patients can be self-walking 21(28 %).

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Effect of Chungpaesagan-tang on ischemic damage induced by MCAO in spontaneously hypertensive rats

  • Kim, Ko-Eun;Kim, Soo-Yong;Kim, Eun-Young;Kim, Bum-Hoi;Shin, Jung-Won;Lee, Hyun-Sam;Sohn, Young-Joo;Jung, Hyuk-Sang;Sohn, Nak-Won
    • Advances in Traditional Medicine
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    • v.8 no.4
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    • pp.430-439
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    • 2008
  • Chungpaesagan-tang (CPSGT) is most frequently used to treat ischemic brain injury in tradition Korean medicine. Clinically, cerebral ischemia is likely to be accompanied by preexisting or complicating disease. However, animal models used to examine the effects of herbal medicines on cerebral ischemia have not given this issue sufficient consideration. The present study was undertaken to determine the effects of CPSGT on focal cerebral ischemia in normal and SHR rats subjected to transient middle cerebral artery occlusion (MCAO). Animals were divided into four groups: Normal (Sprague-Dawley) rats subjected to MACO (the NC+MCAO group), normal rats subjected to MCAO and then administered CPSGT (NC + MCAO + CP), SHR rats subjected to MCAO (SHR + MCAO), and SHR rats subjected to MCAO and then administered CPSGT (SHR + MCAO + CP). MCAO was performed using the intraluminal method. CPSGT was administrated orally twice (1 and 4 h) after MCAO. All animals were sacrificed at 24 h postoperatively. Brain tissues were stained with hematoxylin & eosin, to examine the effect of CPSGT on ischemic brain tissues. In addition, changes in TNF-$\alpha$ expression in ischemic areas were examined by immunostaining. CPSGT was found to significantly reduce infarction areas in normal and SHR rats and infarction volumes in SHR rats. Similarly, CPGST markedly increased neuron numbers and sizes in all treated groups, except cell sizes in SHRs. Furthermore, CPSGT reduced TNF-$\alpha$ expression in MCAO administered SHR rats. The findings of the present study suggest that CPSGT effectively ameliorates neuron damage caused by MACO-induced cerebral ischemia, and that it has a significant neuroprotective effect after cerebral ischemia in SHR.

Cerebral ischemic injury decreases α-synuclein expression in brain tissue and glutamate-exposed HT22 cells

  • Koh, Phil-Ok
    • Laboraroty Animal Research
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    • v.33 no.3
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    • pp.244-250
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    • 2017
  • ${\alpha}$-Synuclein is abundantly expressed in neuronal tissue, plays an essential role in the pathogenesis of neurodegenerative disorders, and exerts a neuroprotective effect against oxidative stress. Cerebral ischemia causes severe neurological disorders and neuronal dysfunction. In this study, we examined ${\alpha}$-synuclein expression in middle cerebral artery occlusion (MCAO)-induced cerebral ischemic injury and neuronal cells damaged by glutamate treatment. MCAO surgical operation was performed on male Sprague-Dawley rats, and brain samples were isolated 24 hours after MCAO. We confirmed neurological behavior deficit, infarction area, and histopathological changes following MCAO injury. A proteomic approach and Western blot analysis demonstrated a decrease in ${\alpha}$-synuclein in the cerebral cortices after MCAO injury. Moreover, glutamate treatment induced neuronal cell death and decreased ${\alpha}$-synuclein expression in a hippocampal-derived cell line in a dose-dependent manner. It is known that ${\alpha}$-synuclein regulates neuronal survival, and low levels of ${\alpha}$-synuclein expression result in cytotoxicity. Thus, these results suggest that cerebral ischemic injury leads to a reduction in ${\alpha}$-synuclein and consequently causes serious brain damage.

Postanesthetic Cerebral Infarction Following Neck Dissection -A case report - (경부청소술 마취 후 발생한 뇌경색 -증례 보고-)

  • Park, Chang-Joe;Lee, Jong-Ho;Kim, Myung-Jin;Kim, Hyun-Jeong;Yum, Kwang-Won
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.1 s.4
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    • pp.34-37
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    • 2003
  • Postoperative stroke is uncommon even in elderly patients, who have a higher incidence of all types of postoperative complications. The mechanism of postoperative stroke is not certain, but can be explained by intravascular clottings originated from thrombus or embolus or by intracranial hemorrhage. In a 66-year-old male patient with current hypertension medication, who underwent both neck dissection for malignancy metastasis under general anesthesia, the left hemiparesis and delayed emergency were found postoperatively. After transferred to intensive care unit, he got the thrombolytic therapy and then the therapies to decrease the swelling of the brain on the diagnosis of cerebral infarction in the vascular distribution of the middle cerebral artery. A brain MRI definitely showed the midline deviation to the left of the right brain hemisphere due to the progressing edematous changes. As he got worse, the emergency neurosurgical operation was proposed but rejected by his family. He died at postoperative 3 days. In this hypertensive patient. perioperative stroke could be originated from the surgical stimuli on major vessels, which were inevitable in neck dissection during the operation. We report this case of the postoperative stroke, which could be highly possible to be associated with extensive head and neck surgery.

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Neuroprotective & antioxidant effects of diets high in n-6 and n-3 fatty acids in rat focal brain ischemia model (N-6와 n-3 지방산이 풍부한 식이가 뇌졸중 유발 모델에서 뇌경색 크기 및 항산화 효소계에 미치는 영향)

  • Lee, Hee-Joo;Park, Kyoung-Ae;Park, Myoung-Sook;Lee, Joung-Hee;Cheon, Sang-Eun;Cheo, Myoung-Ae;Choi, S-Mi
    • Journal of Korean Biological Nursing Science
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    • v.3 no.1
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    • pp.41-52
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    • 2001
  • This study was undertaken to investigate the effects of n-6(corn oil) & n-3(fish oil) fatty acids on infarction size and the cerebral activities of antioxidant enzyme in rat focal brain ischemia model. Weaning Sprague-Dawley rats were fed with either corn oil supplemented diet(COD, 14% corn oil) or fish oil supplemented diet(FOD, 14% menhaden oil) for 6 weeks. The right middle cerebral artery was occluded for 2 hours with a silicon rubber coated nylon surgical thread. After 24 hours of recirculation, the rats were sacrificed and brain sections were photographed using CCD camera after staining with 2, 3, 5-triphenyltetrazolium chloride for 60 minutes in room temperature. The infarcted area was measured and the volume of infarction was calculated. Catalase(CAT), superoxide dismutase(SOD) activities, and fatty acid composition in the brain were also measured. The total and corrected infarction volumes were not significantly different between FOD and COD group. The docosagexaenoic acid(DHA) and DHA content/arachidonic acid(AA) ratio of the cerebral cortex, an index of defense against lipid oxidation, were significantly increased in FOD group compared to those of COD group(p<0.05). In the left cortex(non-infarction side) as well as the right cortex(infarction side) of FOD group, CAT and Cu/Zn SOD activities were higher than those of the COD group(p<0.05). However, CAT and Cu/Zn SOD activities were not significantly different between the left cortex(non-infarction side) and the right cortex(infarction side) of both FOD and COD group. GPx activities were also not significantly different between two groups. Our results demonstrate that the brain infarction size in FOD and COD were not significantly different. However, cerebral lipid composition and antioxidant enzyme activities in FOD and COD group were different. Fish oil, a source of n-3 polyunsaturated fatty acid(PUFA) and corn oil, that of n-6(PUFA) may have a protective effect against oxidative stress induced via different mechanisms.

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Neuroprotective Effect of Heyneanol A from the roots of vitis amurensis Rup (왕머루포도 뿌리에서 분리한 heyneanol A의 신경보호효과)

  • Hwang, Hwa-Soo;Namgung, Mi-Ae;Lee, Eun-Ok;Shim, Bum-Sang;Ahn, Kyoo-Seok;Kim, Sung-Hoon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1411-1414
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    • 2007
  • According to the report of Korea National Statistical Office in 2007, cerebral vascular disease is second cause of deaths in Korean. Cerebral ischemia is one of the main reason of cerebral vascular diseases. To evaluate the neuroprotective effect of heyneanol A against cerebral ischemia, we used the middle cerebral artery occlusion model (MCAO). Heyneanol A from root of vitis amurensis Rup is a tetramer of resveratrol as known anti-oxidant and anti-cancer agent. Although the effects of resveratrol in the various fields have been well established, little is known of the effects of heyneanol A. In this study, heyneanol A reduced infarction and edema volume by 33.5% and 57% compared with control groups (vehicle), respectively. Also, neurological score was decreased by heyneanol A. It's effects were more potent than resveratol. Taken together, these results exerted that heyneanol A has a neuroprotective effect against cerebral ischemia.

Preoperative Evaluation and Significance of Carotid Resection in Advanced Cervical Metastatic Cancer (진행된 경부 전이암에서 경동맥 절제를 위한 술전검사와 절제술의 의의)

  • Cho Jung-Il;Kim Young-Mo;Choi Won-Suk;Choi Sang-Hak;Han Chang-Joon
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.1
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    • pp.13-18
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    • 2001
  • Objectives: We studied what is the role of elective carotid artery resection in the management of advanced cervical metastatic cancer. Materials and Methods: 5 patients with elective carotid artery resection in advanced metastatic cervical cancer were reviewed retrospectively. The patients underwent complete neuroradiologic evaluation, including CT/MRI. angiography, duplex doppler, balloon occlusion test with EEG, and brain SPECT for determination of compatible collateral circulation after carotid artery resection. Results: Perioperative complication were appeared in 2 patients those were middle cerebral arterial infarction and mediastinal bleeding. Postoperative mortality rate was 20%. 4 patients recurred within 1 year. Conclusion: Preoperative collateral study rarely provide whether resection carotid artery or not. Elective carotid artery resection cannot provide locoregional control of tumor and don't promote survival.

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Paradoxical Lateralization of Convulsive Movements in a Subtle Status Epilepticus (미세 간질중첩증에서의 역설적 편측화)

  • Sohn, Eun-Hee;Jung, Ki-Young;Kim, Jae-Moon
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.137-139
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    • 2002
  • Background : Subtle status epilepticus (SE) is an end-stage of convulsive SE. This phenomenon might be a clinical expression of neuronal exhaustion caused by sustained electrical discharges. As subtle SE may show diverse clinical features, early detection depends on clinical suspicion. Case : A 68-year-old woman was presented with repetitive involuntary movement of right limbs after two generalized tonic-clonic seizures. She experienced right middle cerebral artery infarction 4 months ago, and after the event, left side hemiplegia sustained. These seizures were first-ever after the cerebral infarction. Orientation and verbal responses were fairly preserved but general cognitive function was minimally slowed. During the video-EEG monitoring, repetitive sharp waves were noted in the right hemisphere and these sharp waves occasionally spread to the contralateral side. Her right side involuntary movement was identifiable when the epileptic discharges were found on her right hemisphere. Conclusion : We suggested that this unexpected convulsive movement is a reflection of earlier exhaustion in the right hemisphere or deefferentation of right hemisphere because of preexisting neuronal damage.

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Intra-Arterial Thrombolysis Using Double Devices: Mechanicomechanical or Chemicomechanical Techniques

  • Park, Hyun;Hwang, Gyo-Jun;Jin, Sung-Chul;Bang, Jae-Seung;Oh, Chang-Wan;Kwon, O-Ki
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.75-80
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    • 2012
  • Objective : To optimize the recanalization of acute cerebral stroke that were not effectively resolved by conventional intraarterial thrombolysis (IAT), we designed a double device technique to allow for rapid and effective reopening. In this article, we describe the feasibility and efficacy of this technique. Methods : From January 2008 to September 2009, twenty patients with acute cerebral arterial occlusion (middle cerebral artery : n=12; internal carotid artery terminus : n=5; basilar artery : n=3) were treated by the double device technique. This technique was applied when conventional thrombolytic methods using drug, microwires, microcatheters and balloons did not result in recanalization. In the double device technique, two devices are simultaneously placed at the lesion (for example, one microcatheter and one balloon or two microcatheters). Chemicomechanical or mechanicomechanical thrombolysis was performed simultaneously using various combinations of two devices. Recanalization rates, procedural time, complications, and clinical outcomes were analyzed. Results : The initial median National Institute of Health Stroke Scale (NIHSS) was 16 (range 5-26). The double device technique was applied after conventional IAT methods failed. Recanalization was achieved in 18 patients (90%). Among them, 55% (11 cases) were complete (thrombolysis in cerebral infarction 2B, 3). The median thrombolytic procedural time including the conventional technique was $135{\pm}83.7$ minutes (range 75-427). Major symptomatic hemorrhages (neurological deterioration ${\geq}4$ points in NIHSS) developed in two patients (10%). Good long term outcomes (modified Rankin Scale ${\leq}2$ at 90 days) occurred in 25% (n=5) of the cases. Mortality within 90 days developed in two cases (10%). Conclusion : The double device technique is a feasible and effective technical option for large vessel occlusion refractory to conventional thrombolysis.

Effects of different parts of Angelica gigas Nakai on brain damages and neuronal death in transient middle artery occlusion/reperfusion-induced ischemic rats (허혈성 뇌졸중 흰쥐에서 당귀의 부위에 따른 뇌신경보호효과 비교 연구)

  • Shin, Yong-Joon;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.29 no.6
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    • pp.85-93
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    • 2014
  • Objectives : We compared with the effects of different parts (root head, root body and hairy root) of Angelica gigas Nakai (Angelicae Gigantis Radix, AG) with on middle cerebral artery occlusion(MCAO)-induced ischemic rats, and on LPS-induced inflammatory response in BV2 microglia. Methods : The 30% ethanol and water extracts of different parts of AG were prepared. Each extract (50 and 100 mg/kg) was administrated intraperitoneally once in MCAO-induced ischemic rats. We measured infarction volumes by TTC staining, and investigated the expression of iNOS, Bax, Bcl-2 and caspase-3 by Western blot. BV2 cells were treated with each extract for 30 min, and then stimulated with LPS. The levels of NO was measured by Griess assay. The expression of iNOS, Cox-2 and proinflammatory cytokines ($TNF-{\alpha}$, $IL-1{\beta}$, and IL-6) were determined RT-PCR and Western blot. The phosphorylation of ERK1/2 and JNK MAPK was determined by Western blot. Results : Among different parts of AG, the 30% ethanol and water extracts of hairy root significantly decreased infarction volume in ischemic brains and inhibited the expression of iNOS, bax and caspase-3. The extracts of hairy root significantly inhibited LPS-induced production of NO, $TNF-{\alpha}$ and IL-6 in BV2 cells, and suppressed the expression of iNOS and COX-2. The hairy root extracts attenuated LPS-induced phosphorylation of ERK1/2 and JNK MAPK in BV2 cells. Conclusions : Our results indicate that the root hairy of AG has a good neuroprotective and anti-inflammatory effects in ischemic stroke compared to other parts.