• Title/Summary/Keyword: Neurological patient

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Tension Pneumocephalus Secondary to Frontal Sinusotomy in a Dog

  • Seoyeoun Ji;Hyung-Kyu Chae;Yeon-Jung Hong
    • Journal of Veterinary Clinics
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    • v.41 no.4
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    • pp.223-227
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    • 2024
  • Air accumulation in the cranial cavity is referred to as pneumocephalus. Tension pneumocephalus is a neurosurgical emergency that can cause headaches, seizures, reduced consciousness, and even death owing to increased intracranial pressure. We report a case of tension pneumocephalus. The patient underwent a frontal sinusotomy for a mass invading the frontal sinus and nasal cavity. One month later, the patient was admitted to the emergency room with seizures and neurotic symptoms, and computed tomography (CT) revealed tension pneumocephalus with significant gas dilatation of both lateral ventricles. Prompt treatment of the dural defect resulted in the immediate improvement of neurological signs. A CT re-examination 1 week after surgery showed that the pneumocephalus had completely resolved. Tension pneumocephalus should be considered a potential complication in patients with worsening neurological signs after skull base surgery. An accurate diagnosis requires an understanding of imaging features and a high index of suspicion, and immediate intervention is essential.

Effect of Systematic Educational Program for the Application of National Institutes of Health Stroke Scale (NIHSS) as a Neurologic Assessment Tool in Stroke Patients (뇌졸중의 신경학적 사정 도구인 NIHSS 적용을 위한 체계적인 간호사 교육 프로그램의 효과)

  • Han, Jung Hee;Lee, Gee Eun;An, Young Hee;Yoo, Sung Hee
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.1
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    • pp.57-68
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    • 2013
  • Purpose: In assessing patients' neurological status following a stroke it is very important to have a valid tool for early detection of neurological deterioration. NIHSS is considered the best tool to reflect neurological status in patients with ischemic stroke. An education program on use of NIHSS was planned for nurses caring for these patients and the effects of the program were evaluated. Methods: The NIHSS education program (NEP) which includes online and video lectures, and practical education was provided to the nurses from April to July, 2010. To examine the effect of NEP, nursing records of patients with ischemic stroke who were admitted to a stroke center were analyzed. Two groups, a historical control group (n=100) and the study group (n=115) were included. Results: Nursing records for neurologic symptoms for each patient increased (41.0% versus 100.0%, p<.001), and especially, visual disturbance, facial palsy. limb paralysis and ataxia, language disturbance, dysarthria, and neglect symptoms significantly increased (all p<.001). Nurse notification to the doctor of patients with neurological changes increased (21.0% versus 39.1%, p=.004), and nurses' neurological deterioration detection rates also increased (37.5% versus 84.6%, p=.009). Conclusion: NEP improved the quality of nursing records for neurological assessment and the detection rate of neurological deterioration.

Gamma Knife Radiosurgery after Stereotactic Aspiration for Large Cystic Brain Metastases

  • Park, Won-Hyoung;Jang, In-Seok;Kim, Chang-Jin;Kwon, Do-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.360-364
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    • 2009
  • Objective : Several treatment options have proven effective for metastatic brain tumors, including surgery and stereotactic radiosurgery. Tumors with cystic components, however, are difficult to treat using a single method. We retrospectively assessed the outcome and efficacy of gamma knife radiosurgery (GKRS) for cystic brain metastases after stereotactic aspiration of cystic components to decrease the tumor volume. Methods : The study population consisted of 24 patients (13 males, 11 females; mean age, 58.3 years) with cystic metastatic brain tumors treated from January 2002 to August 2008. Non-small cell lung cancer was the most common primary origin. After Leksell stereotactic frame was positioned on each patient, magnetic resonance images (MRI)-guided stereotactic cyst aspiration and GKRS were performed (mean prescription dose : 20.2 Gy). After treatment, patients were evaluated by MRI every 3 or 4 months. Results : After treatment, 13 patients (54.2%) demonstrated tumor control, 5 patients (20.8%) showed local tumor progression, and 6 patients (25.0%) showed remote progression. Mean follow-up duration was 13.1 months. During this period, 10 patients (41.7%) died, but only 1 patient (4.2%) died from brain metastases. The overall median survival after these procedures was 17.8 months. Conclusion : These results support the usefulness of GKRS after stereotactic cyst aspiration in patients with large cystic brain metastases. This method is especially effective for the patients whose general condition is very poor for general anesthesia and those with metastatic brain tumors located in eloquent areas.

A Case Report of Craniosacral Therapy and Acupuncture for Chronic Migraine (두개천골요법과 침치료로 호전된 만성 편두통 환자에 대한 증례보고)

  • Su-jin Lee;Seong-Uk Park;Jung-Mi Park;Chang-Nam Ko;Seung-Yeon Cho
    • The Journal of Korean Medicine
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    • v.44 no.3
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    • pp.140-149
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    • 2023
  • Objectives: This case report aims to describe the effects of craniosacral therapy and acupuncture in a patient with chronic migraine. Methods: A 33-year-old man with chronic migraine was treated with 20 sessions of craniosacral therapy and acupuncture for 8 weeks. The number of migraine and headache days were monitored every month. The pain intensity of headache was measured on the visual analog scale (VAS). Korean Headache Impact Test-6 (HIT-6) and Migraine Specific Quality of Life (MSQoL) were also used. Results: The number of headache days per month reduced from 28 to 7 after 8 weeks of treatment and to 3 after 3 months of treatment. The pain intensity of headache based on VAS reduced from 7.5 to 3 after 8 weeks and further to < 1 after 3 months of treatment. Furthermore, the patient's HIT-6 and MSQoL scores improved during the treatment period, which was maintained or further improved at the 3 month follow-up. No side effects were observed during or after the treatment. Conclusion: This case indicates that craniosacral therapy and acupuncture could be effective treatments for chronic migraine. Further studies are required to validate the efficacy of craniosacral therapy for chronic migraine.

Ruptures Lumbar Disc in a Patient Undergoing Lumbar Chuna Treatment : A Case Report (추나요법 후 악화된 요추 추간판 탈출증 1례)

  • Cho, Jae-Heung;Ryu, Han-Jin;Lee, Jong-Soo;Youn, You-Suk
    • The Journal of Korea CHUNA Manual Medicine
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    • v.5 no.1
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    • pp.163-168
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    • 2004
  • The occurrence of neurologic symptom, for example cauda equina syndrome or disc rupture after Chuna treatment seems to be an uncommon event considering the large number of Chuna treatment performed. We experienced a woman who developed sudden complication after lumbar Chuna treatment. Patients in spinal hernation undergone Chuna treatment can be the causative factor in neurological symptom and must be considered in each case. Therefore, physicans and patients should be aware that neurological complication may occur as a result of lumba Chuna treatment.

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Osteoid Osteoma of the Thoracic Spine - Case Report - (흉추에 발생한 유골 골종 - 증례보고 -)

  • Yun, Byung Min;Rhim, Seung Chul;Roh, Sung Woo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.291-295
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    • 2000
  • A 22-year-old man is presented with 3 months' history of dull pain on the lower thoracic area. Imaging studies suggested osteoid osteoma of 11th thoracic spine, which was verified pathologically after en bloc resection through transfacetal approach. The patient's preoperative pain was resolved immediately. We emphasize the importance of early diagnosis and complete surgical excision of tumor nidus.

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Endolymphatic Sac Tumors : Report of Four Cases

  • Bae, Chae-Wan;Cho, Young-Hyun;Chung, Jong-Woo;Kim, Chang-Jin
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.268-272
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    • 2008
  • Endolymphatic sac tumor is rare, locally aggressive hypervascular tumor of papillary structure, arising from the endolymphatic duct or sac in the posterior petrous bone. We present four cases with this tumor. Two patients were male and the other two were female. Age of each patient was 15, 52, 58, and 67 years. Three patients presented with progressive hearing loss and sustained vertigo for months to years and another one was referred for the tumor detected in routine medical check-up. Preoperative embolization was performed in 3 patients. Complete excision of the tumor was achieved in all patients using translabyrinthine or retrosigmoid approach. Herein, we describe the clinical and radiographic features, surgical treatment and pathologic findings with a review of the literature.

Dural Arteriovenous Fistula of Jugular Foramen with Subarachnoid Hemorrhage : Selective Transarterial Embolization

  • Byun, Jun-Soo;Hwang, Sung-Nam;Park, Seung-Won;Nam, Taek-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.199-202
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    • 2009
  • We report the case of a 64-year-old man with dural arteriovenous fistula (DAVF) at right jugular foramen, presented as subarachnoid and intraventricular hemorrhage. The malformation was fed by only the neuromeningeal trunk of the right ascending pharyngeal artery and drained into the right lateral medullary veins craniopetally. Complete embolization was attained by selective transarterial glue injection, but patient showed lower cranial neuropathies. A 3-month follow-up angiogram still showed persistent fistula occlusion. Transarterial glue embolization is a feasible method, only if a transvenous access is not possible in case of single channel fistula.

Adverse Events Associated with Intravenous Immunoglobulin Therapy in Neuromuscular Disorders (신경근질환의 정맥 내 면역글로불린 치료와 연관된 유해사례)

  • Na, Sang-Jun;Choi, Young-Chul
    • Annals of Clinical Neurophysiology
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    • v.8 no.1
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    • pp.48-52
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    • 2006
  • Background: Intravenous immunoglobulin (IVIg) has been administered for various immune-mediated neurological diseases such as autoimmune neuropathy, inflammatory myopathies, and other autoimmune neuromuscular disorders. The purpose of this study is to investigate side effects and complications of IVIg therapy in neuromuscular disorders. Methods: We enrolled 29 patients (age 8~63 years) with IVIg therapy for various neurological diseases including Guillain-Barre syndrome, myasthenia gravis, dermatomyositis, polymyositis, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. IVIg therapy was used at a dose of 0.4 g/kg body weight/day for 5 consecutive days. Results: 10 patients (34%) had adverse events. There are adverse events in 16 courses (11%) among total 145 courses. The majority of patients presented with mild side effects, mostly asymptomatic laboratory changes. Rash or mild headache occurred in 3 patients. One patient showed a serious side effect of deep vein thrombosis. Conclusions: IVIg therapy is safe for a variety of immune-mediated neurological diseases in our study.

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Neurological aspects of anhidrosis: differential diagnoses and diagnostic tools

  • Park, Kee Hong;Park, Ki-Jong
    • Annals of Clinical Neurophysiology
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    • v.21 no.1
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    • pp.1-6
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    • 2019
  • Anhidrosis refers to the condition in which the body does not respond appropriately to thermal stimuli by sweating. Sweating plays an important role in maintaining the body temperature, and its absence should not be overlooked since an elevated body temperature can cause various symptoms, even leading to death when uncontrolled. The various neurological disorders that can induce anhidrosis make a detailed neurological evaluation essential. The medication history of the patient should also be checked because anhidrosis can be caused by various drugs. The tests available for evaluating sweating include the quantitative sudomotor axon reflex sweat test, thermoregulatory sweat test, sympathetic skin response, and electrochemical skin conductance. Pathological findings can also be checked directly in a skin biopsy. This review discusses the differential diagnosis and evaluation of anhidrosis.