• Journal of Trauma and Injury
• /
• v.34 no.3
• /
• pp.203-207
• /
• 2021

Penetrating brain injury caused by a nail gun is an uncommon clinical scenario reported in the literature. A 36-year-old male presented with a nail that had penetrated through the occipital bone. He was alert and neurologically intact except for visual disturbance. Computed tomography (CT) of the brain showed the nail lodged at the occipital lobe and the parietal lobe, with minimal intracerebral hemorrhage. The nail was placed in the occipital lobe close to the superior sagittal sinus. We removed the nail with craniotomy since the entrance of the nail was close to the superior sagittal sinus. There were no newly developed neurological deficits postoperatively. Immediate postoperative CT showed no newly developed lesions. The patient recovered well without any significant complications. Two weeks postoperatively, magnetic resonance imaging showed no remarkable lesions. The visual disturbance was followed up at the outpatient department. To summarize, we report a rare case of penetrating head injury by a nail gun and discuss relevant aspects of the clinical management.

• Journal of Korean Neurosurgical Society
• /
• v.65 no.1
• /
• pp.40-48
• /
• 2022

Objective : Placement of a single transverse stent via the nondominant A1 across the anterior communicating artery (AComA) into the contralateral A2 can provide sufficient neck coverage for wide-necked bifurcation AComA aneurysms. The authors described the feasibility, safety and long-term outcomes of this technique. Methods : Between January 2015 and February 2018, placement of a single transverse stent via the nondominant A1 was attempted in 17 wide-necked bifurcation AComA aneurysms. The authors reviewed the medical records and radiological studies. Results : The technical success rate was 94.1% (16/17). Periprocedural thromboembolic complications occurred in one patient (6.3%) without permanent neurological deficits. The mean clinical follow-up duration was 39.9±9.8 months. No deaths or delayed thromboembolic complications occurred. The mean angiographic follow-up duration was 38.9±9.8 months. The immediate and final follow-up complete occlusion rates were 87.4 and 93.7%, respectively. There was no recanalization during the follow-up period. Conclusion : Placement of a single transverse stent via the nondominant A1 across the AComA into the contralateral A2 is a feasible and relatively safe endovascular technique for the treatment of wide-necked bifurcation AComA aneurysms, with good long-term occlusion rates and a reasonable complication rate, if only the nondominant A1 is applicable.

• Journal of Korean Foot and Ankle Society
• /
• v.26 no.3
• /
• pp.136-142
• /
• 2022

Lateral compartment syndrome of the lower leg is rarely observed. Hence, there may be difficulty in diagnosis as its clinical patterns are different and more complicated than usual. We report two rare cases of a 20-year-old and a 28-year-old diagnosed with isolated lateral compartment syndrome who had either a surgical or conservative treatment. The comparison was done by analyzing the progression of neurological manifestation, electromyography, and nerve conduction study for two years. In the final follow-up, the patient who underwent the surgical treatment showed a shorter recovery time. However, both patients showed a full recovery from neurologic deficits.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.20 no.1
• /
• pp.22-24
• /
• 2022

Elapid snakes have neurotoxic venom which causes diverse neuroparalytic manifestations, including fatal respiratory failure. In South Korea, since elapid snakebites are very rare, the cobra antivenom, which is effective against neurotoxicity, was only introduced recently. Most physicians in South Korea have little experience in the treatment of patients who have been bitten by elapid snakes. A 19-year-old man was brought to the emergency department with sudden diplopia, 1 hour after a snakebite on the left 2nd finger. The patient presented with drowsiness and complained of mild dizziness and binocular diplopia. After 1 hour, he had sudden onset of dyspnea and dysphagia and appeared to be agitated. He was immediately intubated and received mechanical ventilation as he was unable to breathe on his own. A total of 2.5 mg of neostigmine diluted with normal saline was slowly infused, and 1 vial of cobra antivenom was infused for an hour, 5 times every 2 hours, for a total of 5 vials. He slowly recovered self-breathing; on the 3rd day of hospitalization, he showed tolerable breathing and was extubated. He was discharged without any neurological deficits or other complications.

• Korean Journal of Veterinary Research
• /
• v.62 no.4
• /
• pp.27.1-27.4
• /
• 2022

A 2-year-old spayed female Border Collie presented with visual deficits and behavioral changes. Neurological examination revealed bilateral menace response deficit with a normal pupil light reflex. Cerebral cortical thinning, cerebral sulci and cerebellar fissure widening, ventriculomegaly, and cerebral atrophy were observed on magnetic resonance imaging (MRI). Histopathology revealed fluorescent lipopigment accumulation in the cerebrum, and the dog was diagnosed with neuronal ceroid lipofuscinosis. This is the first case report describing the changes in clinical signs, MRI findings, and histopathologic changes in neuronal ceroid lipofuscinosis in Korea.

• Tuberculosis and Respiratory Diseases
• /
• v.86 no.2
• /
• pp.102-110
• /
• 2023

Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 600 million confirmed cases and 6 million deaths by 15 December 2022. Although the acute phase of COVID-19 management has been established, the long-term clinical course and complications due to the relatively short outbreak is yet to be assessed. The current COVID-19 pandemic is causing significant morbidity and mortality around the world. Interestingly, epidemiological studies have shown that fatality rates vary considerably across different countries, and men and elderly patients are at higher risk of developing severe diseases. There is increasing evidence that COVID-19 infection causes neurological deficits in a substantial proportion to patients suffering from acute respiratory distress syndrome. Furthermore, lack of physical activity and smoking are associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) susceptibility. We should therefore explore why lack of physical activity, smoking, etc causing a population more susceptible to SARS-CoV-2 infection, and mechanism involved. Thus, in this review article, we summarize epidemiological evidence related to risk factors and lifestyle that affect COVID-19 severity and the mechanism involved. These risk factors or lifestyle interventions include smoking, cardiovascular health, obesity, exercise, environmental pollution, psychosocial social stress, and diet.

• Biomolecules & Therapeutics
• /
• v.32 no.3
• /
• pp.319-328
• /
• 2024

Lysophosphatidic acid receptor 1 (LPA₁) plays a critical role in brain injury following a transient brain ischemic stroke. However, its role in permanent brain ischemic stroke remains unknown. To address this, we investigated whether LPA₁ could contribute to brain injury of mice challenged by permanent middle cerebral artery occlusion (pMCAO). A selective LPA₁ antagonist (AM152) was used as a pharmacological tool for this investigation. When AM152 was given to pMCAO-challenged mice one hour after occlusion, pMCAO-induced brain damage such as brain infarction, functional neurological deficits, apoptosis, and blood-brain barrier disruption was significantly attenuated. Histological analyses demonstrated that AM152 administration attenuated microglial activation and proliferation in injured brain after pMCAO challenge. AM152 administration also attenuated abnormal neuroinflammatory responses by decreasing expression levels of pro-inflammatory cytokines while increasing expression levels of anti-inflammatory cytokines in the injured brain. As underlying effector pathways, NF-κB, MAPKs (ERK1/2, p38, and JNKs), and PI3K/Akt were found to be involved in LPA₁-dependent pathogenesis. Collectively, these results demonstrate that LPA₁ can contribute to brain injury by permanent ischemic stroke, along with relevant pathogenic events in an injured brain.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.11
• /
• pp.1291-1299
• /
• 2001

Objectives : The authors present a retrospective analysis of 14 patients treated for spinal cord hemangioblastoma (SCH) between Dec. 1986 and Mar. 2000. This study was conducted to evaluate and compare the difference of the functional outcomes associated with the extent of surgical removal of SCH. Methods : Eleven patients were male and three patients were female. Their mean age was 37.2 years that ranged from 19 to 62 years. Preoperative magnetic resonance(MR) imaging of the spine was performed in all cases, and preoperative angiography in eleven cases. They were followed from 15 months to 161 months(median follow-up period, 47 months), and we investigated the change of neurological symptoms and functional outcomes with radiological features, especially on MR imaging. Results : Six patients were accompanied by von Hippel-Lindau disease, and three of them had multiple CNS tumors. Thirteen patients had intramedullary tumor, and the remaining one had extradural. Syringomyelia around the tumor was observed in ten cases. All patients underwent surgical removal, and gross total removal(GTR) was achieved in ten cases. Preoperative embolization was performed in four cases. In four patients who were treated with preoperative embolization, intraoperative loss of blood was minimal and GTR was possible. One patient developed a transient swallowing difficulty postoperatively without permanent postoperative neurological deficits. In three of four patients in whom GTR was not possible, their functional outcomes were worsened postoperatively. The functional status at discharge was improved in seven patients, stationary in four patients, and worse in three. At the last follow-up(15-161 months), one of four patients who had been stationary at discharge showed improvement but, the rest did not show any change. All patients who showed neurological improvement were patients with GTR, and the patients with GTR had significant better outcome than those without GTR(p=0.015). Conclusion : Surgical treatment, and especially, GTR is considered as treatment of choice for spinal cord hemangioblastoma. Preoperative embolization may prevent intraoperative bleeding and improve surgical outcome.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.1 no.1
• /
• pp.55-64
• /
• 1990

The purpose of the present study is to investigate cognitive characteristics of ADHD children by comparing their performances on KEDI-WISC according to age and EEG variables. Subjects were 56 ADHD children who visited Seoul National University Children's Hospital during the period from January, 1988 to March, 1989. Group differences on age and EEG variables were tested by ANOVA, and Hierarchical Cluster Analysis was performed to investigate how ADHD children were classified based on their performances on KEDI-WISC. The results Indicated that ADHD children showed low scores on Coding, Digit Span, and Comprehension subtests, suggesting their attention deficits and impulsivity. ADHD children were clustered Into three groups based on only FSIQ. In post-hoc tests three groups showed different cognitive strengths and weaknesses on KEDI-WISC. Group differences on age were not significant, and abnormal EEG group showed lower PIQ than normal EEG group, suggesting the possibility that their attention deficits were related to neurological factors.

• Journal of Veterinary Clinics
• /
• v.32 no.5
• /
• pp.464-468
• /
• 2015

A 6-year-old, intact male maltese was presented with hindlimb ataxia of 4 day duration. Physical and neurological examinations revealed a bright, alert, and responsive dog, with no evidence of cranial nerve deficits, conscious proprioceptive deficits. Spinal reflexes of the hind and forelimbs were normal. Patellar, cranial tibial, and withdrawal reflexes were normal. Pain could not be elicited on manipulation of the neck or palpation of the spinal column. Survey radiographs of the vertebral column were unremarkable. Computed tomography (CT) scans in the transverse plane were performed. The results of CT imaging were unremarkable. Magnetic resonance imaging (MRI) in both sagittal and transverse planes was performed. The extent of the lesion was 25 mm in length by 4 mm in thickness. The spinal cord was deviated ventrally and appreared thinner. On T1-weighted and FLAIR images, a discrete hypointense lesion dorsal to the spinal cord was observed at L1-2 which was contiguous with the subarachnoid space. On T2-weighted images, this region was hyperintense, consistent with a fluid-filled structure. The signal intensity of the cysts was equivalent to cerebrospinal fluid (CSF). Surgical treatment involving dorsal laminectomy had successful outcomes.