• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.306-309
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• 2016

Using diffusion tensor tractography (DTT), we demonstrated injury of the arcuate fasciculus (AF) in the nondominant hemisphere in two patients who showed subfalcine herniation after intracerebral hemorrhage (ICH) in the dominant hemisphere. Two patients (patient 1 and patient 2) with ICH and six age-matched control patients who have ICH on the left corona radiata and basal ganglia without subfalcine herniation were recruited for this study. DTT was performed at one month after onset in patient 1 and patient 2. AFs of both hemispheres in both patients were disrupted between Wernicke's and Broca's areas. The fractional anisotropy value and tract numbers of the right AFs in both patients were found to be more than two standard deviations lower than those of control patients. In contrast, the apparent diffusion coefficient value was more than two standard deviations higher than those of control patients. Using the configuration and parameters of DTT, we confirmed injury of the AF in the nondominant hemisphere in two patients with subfalcine herniation following ICH in the dominant hemisphere. Therefore, DTT would be a useful tool for detection of underlying injury of the AF in the nondominant hemisphere in patients with subfalcine herniation.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.326-330
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• 2007

Objective : Stroke is the most prevalent disease involving the central nervous system. Since medical modalities are sometimes ineffective for the acute edema following massive infarction, surgical decompression may be an effective option when medical treatments fail. The present study was undertaken to assess the outcome and prognostic factors of decompressive surgery in life threatening acute, severe, brain infarction. Methods : We retrospectively analyzed twenty-six patients (17 males and 9 females; average age, 49.7yrs) who underwent decompressive surgery for severe cerebral or cerebellar infarction from January 2003 to December 2006. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : Of the 26 patients, 5 (19.2%) showed good recovery, 5 (19.2%) showed moderate disability, 2 (7.7%) severe disability, 6 (23.1%) persistent experienced vegetative state, and 8 (30.8%) death. In this study, the surgical decompression improved outcome for cerebellar infarction, but decompressive surgery did not show a good result for MCA infarction (30.8% overall mortality vs 100% mortality). The dominant-hemisphere infarcts showed worse prognosis, compared with nondominant-hemisphere infarcts (54.5% vs 70%). Poor prognostic factors were diabetes mellitus, dominant-hemisphere infarcts and low preoperative Glasgow Coma Scale (GCS) score. Conclusion : The patients who exhibit clinical deterioration despite aggressive medical management following severe cerebral infarction should be considered for decompressive surgery. For better outcome, prompt surgical treatment is mandatory. We recommend that patients with severe cerebral infarction should be referred to neurosurgical department primarily in emergency setting or as early as possible for such prompt surgical treatment.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.1
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• pp.46-50
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• 2015

The previous studies showed that the visual imagery activated the occipital and posterior inferior temporal area of the brain, and the damage to the occipital cortex impaired the visual mental imagery. We studied current-source distribution of electroencephalography (EEG) to observe neuronal activity during imagery tennis playing. Eleven healthy volunteers were enrolled. All volunteers were right-handed males and novices for tennis playing. The mean age of them was 24.9 years. The EEGs were recorded on the scalp electrodes located according to the International 10~20 System. The number of electrodes was 25 channels including subtemporal electrodes. The EEG recording session was 13 min including 5 segments: resting-I, scenery-slide show, resting-II, watching tennis-game video, and imagery-tennis playing. The recoding durations were 3, 2, 3, 2, and 3 min respectively. Five 'artifact free 3-sec segments' were selected in each segment of 'imagery-tennis playing' and 'resting-II'. We did the frequency domain analysis with the EEG segments using a distributed model of current-source analysis. The statistical-nonparametric maps (SnPMs) were obtained between the segments of 'imagery-tennis playing' and the segments of 'resting-II' (p<0.01). The significant change of current-source density was observed only in alpha-2 frequency band (10~12 Hz). The current-sourcedensity was increased in the hippocampus, parahippocampus, and occipital fusiform gyrus in the right cerebral hemisphere (p<0.01). Imaginary-tennis playing may activate the hippocampal-occipital alpha networks of nondominant hemisphere.