• 제목/요약/키워드: Neurological symptoms

검색결과 525건 처리시간 0.025초

Intracisternal Cranial Root Accessory Nerve Schwannoma Associated with Recurrent Laryngeal Neuropathy

  • Jin, Sung-Won;Park, Kyung-Jae;Park, Dong-Hyuk;Kang, Shin-Hyuk
    • Journal of Korean Neurosurgical Society
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    • 제56권2호
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    • pp.152-156
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    • 2014
  • Intracisternal accessory nerve schwannomas are very rare; only 18 cases have been reported in the literature. In the majority of cases, the tumor origin was the spinal root of the accessory nerve and the tumors usually presented with symptoms and signs of intracranial hypertension, cerebellar ataxia, and myelopathy. Here, we report a unique case of an intracisternal schwannoma arising from the cranial root of the accessory nerve in a 58-year-old woman. The patient presented with the atypical symptom of hoarseness associated with recurrent laryngeal neuropathy which is noted by needle electromyography, and mild hypesthesia on the left side of her body. The tumor was completely removed with sacrifice of the originating nerve rootlet, but no additional neurological deficits. In this report, we describe the anatomical basis for the patient's unusual clinical symptoms and discuss the feasibility and safety of sacrificing the cranial rootlet of the accessory nerve in an effort to achieve total tumor resection. To our knowledge, this is the first case of schwannoma originating from the cranial root of the accessory nerve that has been associated with the symptoms of recurrent laryngeal neuropathy.

Successful Treatment of a Symptomatic Discal Cyst by Percutaneous C-arm Guided Aspiration

  • Yu, Hyun Jeong;Park, Chan Jin;Yim, Kyoung Hoon
    • The Korean Journal of Pain
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    • 제29권2호
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    • pp.129-135
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    • 2016
  • Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.

Mercury poisoning in Eurasian river otter (Lutra lutra)

  • Gyurae Kim;Sangjin Ahn;Sang-Joon Lee;Ba-Ra-Da Koh;Soo-Young Choi;Ho-Seong Cho;Yeonsu Oh
    • Journal of Ecology and Environment
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    • 제47권2호
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    • pp.42-48
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    • 2023
  • An adult male Eurasian river otter (Lutra lutra) with ataxia and lethargy was rescued. Through the necropsy of this otter with neurological symptoms, a broad range of vascular damage caused by mercury toxicity in several organs, hepatocellular necrosis, and vacuolation in the brain. In mercury examination, liver, kidney, and hair showed values of 0.878 ± 0.027, 1.807 ± 0.049, and 5.712 ± 0.102 ㎍/g, respectively. Compared with certified reference material, it was confirmed that the concentration of mercury were 6.7 times, 13.7 times, and 43.3 times higher, respectively. When the symptoms and diagnosis results were comprehensively reviewed, this otter's demise was revealed due to mercury poisoning. The mercury concentration in the liver does not exceed the lowest observed effect level of 3.4 ㎍/g. However, even at low concentrations, long-term accumulation can cause symptoms including neuropathy, and the possibility that these heavy metals have accumulated in other wild animals cannot be ruled out. It seems that continuous monitoring using sentinel animals is necessary.

뇌졸중 전문치료실의 간호강도에 근거한 환자분류도구 개발 (Development of Patient Classification System based on Nursing Intensity in Stroke Unit)

  • 김은정;김희정;김미영
    • 간호행정학회지
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    • 제20권5호
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    • pp.545-557
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    • 2014
  • Purpose: The purpose of this study was to develop a patient classification system based on nursing care intensity for patients with acute stroke-related symptoms and verify its validity and reliability. Methods: Data were collected between November, 2013 and February, 2014. The verification for content validity of the patient classification system was conducted by a group of seven professionals. Both interrater reliability and concurrent validity were verified at stroke units in tertiary hospitals. Results: The intensive nursing care for acute stroke patients consisted of 14 classified domains and 56 classified contents by adding 'neurological assessment and observation' and 'respiratory care': 'hygiene', 'nutrition', 'elimination', 'mobility and exercise', 'education or counselling', 'emotional support', 'communication', 'treatment and examination', 'medication', 'assessment and observation', 'neurological assessment and observation', 'respiratory care', 'coordination between departments', and 'discharge or transfer care'. Each domain was classified into four levels such as Class I, Class II, Class III, and Class IV. Conclusion: The results show that this patient classification system has satisfactory validity for content and concurrent and verified reliability and can be used to accurately estimate the demand for nursing care for patients in stroke units.

Migration of Sparganosis from the Brain to the Cervical Spinal Cord

  • Jang, Se-Youn;Kim, Choong-Hyun
    • Journal of Korean Neurosurgical Society
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    • 제51권3호
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    • pp.170-172
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    • 2012
  • Central nervous system (CNS) sparganosis is a rare parasitic infestation caused by ingestion of the raw or inadequately cooked snakes or frogs. Sparganum is well known for its ability of migrating though the tissue, therefore, it can cause various neurological symptoms if it involves neurological systems. A 51-year-old male patient visited our department of neurosurgery complaining of the motor weakness and radiating pain on both upper extremities over 4 months. He had a history of ingesting raw snakes untill his late twenties. The magnetic resonance (MR) images of. cervical spine revealed an intramedullary ill-defined enhancing lesion with the aggregated cysts in the upper cervical spinal cord. Under presumptive diagnosis of sparganosis, we took brain MR image. The brain MR images revealed the signal change in right fronto-temporallobe suggesting the trajectory of parasitic migration via ventricular systems. He underwent a midline myelotomy and granuloma removal followed by the posterior laminoplasty. Pathologic findings showed inflammatory changes and necrosis with keratinized tissue suggesting the CNS sparganosis. We report an uncommon case of CNS sparganosis migrated from the brain to the spinal cord with literature review.

중합효소 연쇄반응을 이용한 Varicella-Zoster Virus DNA 검출로 확인된 대상포진 수막염 -증례 보고- (Herpes Zoster Meningitis Confirmed by Detection of Varicella-Zoster Virus DNA Using the Polymerase Chain Reaction -A case report-)

  • 허후만;최유선;박성규
    • The Korean Journal of Pain
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    • 제18권2호
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    • pp.210-213
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    • 2005
  • Acute viral meningitis and myositis are rare complications of varicella-zoster virus (VZV) reactivation. A 71-years-old immunocompetent man, who presented with lower back pain radiating to the left lower extremities, developed vesicles on the L5 dermatomal area. The next day, he had complained of aberrant vesicles on the trunk, face and scalp, with generalized myalgia, headache and dizziness. He was confirmed with VZV meningitis and myositis, as demonstrated by the presence of VZV DNA in the blood and cerebral spinal fluid using a polymerase chain reaction (PCR) amplification. PCR has been used in patients with a VZV infection associated neurological symptoms, and provides a useful tool for the early diagnosis of VZV-associated neurological disease. The patient was treated with bed rest, with intravenous acyclovir for the VZV infection, and intravenous Patient-controlled Analgesia for pain management and the prevention of postherpetic neuralgia. When he visited the outpatient department 3 months later, the skin lesion, leg pain, headache and myalgia had all improved, without sequelae. Here, this case is reported, with a discussion of the relevant literature on its diagnosis and management.

흉추부에 발생한 자발성 척수 경막외 혈종 - 증 례 보 고 - (Spontaneous Thoracic Epidural Hematoma - Case Report -)

  • 구태헌;목진호;이영배;박용석;이규춘;김한식
    • Journal of Korean Neurosurgical Society
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    • 제29권1호
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    • pp.131-135
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    • 2000
  • Spontaneous spinal epidural hematoma, an idiopathic accumulation of blood in the vertebral epidural space without identifiable predisposing factors, is a rare condition. The diagnosis can be made from a careful history and neurological examination, but clinical diagnosis is often difficult because of its non-specific symptomatology and it can be confused with myocardial infarct, musculoskeletal pain, vasculitis and acute dissection of an aortic aneurysm. For a favourable outcome, early decompressive laminectomy and evacuation of hematoma are necessary. We report a 50-year-old female who presented with acute paraparesis and back pain on thoracic area. Diagnosis of spinal epidural hematoma which extended over $T_4-T_9$ was made by magnetic resonance imaging. We performed immediately decompressive laminectomy and evacuated the epidural hematoma. No cause for bleeding was evident. Postoperatively, neurological symptoms disappeared within six weeks.

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Cryptococcal Brainstem Abscess Mimicking Brain Tumors in an Immunocompetent Patient

  • Hur, Jong Hee;Kim, Jang-Hee;Park, Seoung Woo;Cho, Kyung Gi
    • Journal of Korean Neurosurgical Society
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    • 제57권1호
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    • pp.50-53
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    • 2015
  • Usually fungal infections caused by opportunistic and pathogenic fungi had been an important cause of morbidity and mortality among immunocompromised patients. However clinical data and investigations for immunocompetent pathogenic fungal infections had been rare and neglected into clinical studies. Especially Cryptococcal brainstem abscess cases mimicking brain tumors were also much more rare. So we report this unusual case. This 47-year-old man presented with a history of progressively worsening headache and nausea for 1 month and several days of vomituritions before admission. Neurological and laboratory examinations performed demonstrated no abnormal findings. Previously he was healthy and did not have any significant medical illnesses. A CT and MRI scan revealed enhancing $1.8{\times}1.7{\times}2.0$ cm mass lesion in the left pons having central necrosis and peripheral edema compressing the fourth ventricle. And also positron emission tomogram scan demonstrated a hot uptake of fluoro-deoxy-glucose on the brainstem lesion without any evidences of systemic metastasis. Gross total mass resection was achieved with lateral suboccipital approach with neuronavigation system. Postoperatively he recovered without any neurological deficits. Pathologic report confirmed Cryptococcus neoformans and he was successively treated with antifungal medications. This is a previously unreported rare case of brainstem Cryptococcal abscess mimicking brain tumors in immunocompetent host without having any apparent typical meningeal symptoms and signs with resultant good neurosurgical recovery.

자발성 척수내혈종 - 증례보고 - (Spontaneous Hematomyelia - Case Report -)

  • 황정현;성주경;황성규;함인석;박연묵;김승래
    • Journal of Korean Neurosurgical Society
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    • 제29권3호
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    • pp.411-419
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    • 2000
  • Hematomyelia is an extremely rare condition that cause severe neurological symptoms. We reported 4 cases of spontaneous hematomyelia, two cases of cavernous angioma and two cases of hematoma. In all patients, the clinical course was progressive ; motor and sensory abnormalities below the lesion and voiding difficulties were the common presenting symptom complex. The preoperative diagnosis was made by magnetic resonance imaging and the all patients underwent surgical exploration. Complete removal of hematoma was done in 3 patients and complete evacuation after aspiration of hematoma were performed in one patients. Neurological function did not worsen postoperatively in any patients. The early diagnosis with magnetic resonance imaging and immediate surgical treatment of the hematoma and the associated vascular malformation are considered to be the best way to halt the progression of the disease.

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Childhood Onset of Anti-N-Methyl-D-Aspartate Receptor Encephalitis Without Teratoma Masquerading as a Psychotic Disorder

  • Yeum, Tae-Sung;Lee, Jung;Park, Sung-Yeol;Joen, Yaelim;Kim, Bung-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제30권3호
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    • pp.127-131
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    • 2019
  • Many neurologic disorders manifest as psychiatric symptoms. Anti-N-Methyl-D-Aspartate (NMDA) receptor encephalitis is an autoimmune disease of the brain characterized by numerous neurological and psychiatric features. Despite being rare, its prevalence is rapidly increasing and early management is critical in ensuring successful and sustainable recovery. Therefore, the illness should be considered as a differential diagnosis when clinically assessing patients. This report presents a case of a female child who was hospitalized for acute psychiatric manifestations, which was later confirmed as anti-NMDA receptor encephalitis. She recovered relatively successfully after combined neurological and psychiatric treatment. This report provides information on the clinical course of early onset anti-NMDA receptor encephalitis, including treatment strategy and prognosis.