• Title/Summary/Keyword: Spontaneous intracerebral hemorrhage

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Development and Application of Simulation Learning Scenario using Standardized Patients: Caring for Neurological Patients in Particular (표준화 환자를 활용한 시뮬레이션 학습시나리오 개발 및 적용 : 신경계 환자 간호를 중심으로)

  • Kim, Ye-Eun;Kang, Hee-Young
    • The Journal of the Korea Contents Association
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    • v.13 no.11
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    • pp.236-248
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    • 2013
  • This study was to develop the simulation learning scenario using standardized patients, and to evaluate the effect of it. This study was a pre-post test design with a single group and participants were recruited from fourth-year nursing students at a university. This study has developed the case scenario for a patient with spontaneous intracerebral hemorrhage and the simulation learning using standardized patients, which was applied in this study, had improved problem solving ability and clinical performance ability on nursing students. Through this study, the nursing student will grow up to be a professional nurse by learning the nursing assessment including consciousness assessment. Also, the simulation learning scenario using standardized patient should be developed in the various fields.

Gait Recovery Characteristic According to the Injury Aspect of Descending Motor Pathway in a Chronic Stroke Patient: a Case Study

  • Sang Seok Yeo
    • The Journal of Korean Physical Therapy
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    • v.34 no.6
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    • pp.326-331
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    • 2022
  • Purpose: The stroke patients have gait dysfunction due to impaired neural tracts; corticospinal tract (CST), corticoreticular pathway (CRP), and vestibulospinal tract (VST). In this study, we investigated characteristics of gait pattern according to the injury aspect of the neural track in a stroke patient. Methods: One patient and six control subjects of similar age participated. A 19-year-old male patient with spontaneous intracerebral hemorrhage on right basal ganglia, thalamus, corona radiata and cerebral cortex due to arteriovenous malformation rupture. Diffusion tensor imaging (DTI) data was acquired 21 months after the stroke. Kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 21 months DTI, the CST and CRP in affected hemisphere showed severe injury, in contrast, the VST in affected hemisphere showed intact integrity. Result of gait analysis, walking distance and speed were significantly decreased in a patient. The stance rate of unaffected lower limb, the swing rate of affected lower limb and the duration of double stance significantly increased compared with normal control. The knee and hip joint angle were significantly decreased in a patient. Conclusion: We found recovered independent gait ability may be associated with unimpaired VST in a patient with severe injury in CST and CRP.

Silent Microbleeds and Old Hematomas in Spontaneous Cerebral Hemorrhages

  • Lim, Jae-Bum;Kim, Ealmaan
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.38-44
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    • 2009
  • Objective : The authors studied the risk factors of silent cerebral microbleeds (MBs) and old hematomas (OHs) and their association with concurrent magnetic resonance (MR) imaging findings in the patients of intracerebral hemorrhages (ICHs). Methods : From April 2002 to June 2007, we retrospectively studied 234 patients of primary hemorrhagic stroke. All patients were evaluated with computed tomography (CT) and 3.0-tesla MR imaging studies within the first week of admission. MBs and OHs were assessed by using $T2^{\ast}$-weighted gradient-echo (GRE) MR imaging. The patients were divided into 2 groups, depending on whether or not they had two GRE lesions of chronic hemorrhages. A correlation between MBs and OHs lesions were also statistically tested. Lacunes and white matter and periventricular hyperintensities (WMHs, PVHs) were checked by T1- and T2-weighted spin-echo and fluid attenuated inversion recovery sequences. Variables on the clinical and laboratory data and MR imaging abnormalities were compared between both groups with or without MBs and OHs. Results : MBs were observed in 186 (79.5%) patients and a total of 46 OHs were detected in 45 (19.2%) patients. MBs (39.6%), OHs (80.4%), and ICHs (69.7%) were most commonly located in the ganglionic/thalamic region. Both MBs and OHs groups were more frequently related to chronic hypertension and advanced WMHs and PVHs. The prevalence and number of MBs were more closely associated with OHs groups than non-OH patients. Conclusion : This study clearly demonstrated the presence of MBs and OHs and their correlation with hypertension and cerebral white matter microangiopathy in the ICHs patients. Topographic correlation between the three lesions (MBs, OHs, and ICHs) was also noted in the deep thalamo-basal location.

Case Report of Korean Medicine Treatment and Dressing Therapy for Grade III Trochanteric Pressure Sore (한의 치료와 드레싱 요법을 병행한 뇌졸중 환자의 대퇴골 대전자부 3단계 욕창 치험 1례)

  • Kim, Kwangho;Lee, Young-ung;Kim, Cheol-hyun;Lim, Hyeon-seo;Kang, Geonhui;Lee, Sangkwan
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.122-130
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    • 2021
  • The purpose of this study is to report the effect of Korean medicine treatment on a pressure sore in a stroke patient. An 86-year-old female patient diagnosed with spontaneous intracerebral hemorrhage in the right basal ganglia had symptoms of left hemiparesis, dysphagia, and a 4.5-cm-by-2.5-cm left trochanteric pressure sore. Clinical outcomes were measured using the National Pressure Ulcer Advisory Panel (NPUAP) pressure injury stages, the Agency for Health Care Policy and Research (AHCPR) pressure ulcer stages, and the Braden scales. Treatment with Korean medicine, including acupuncture, herbal medicine, and dressing therapy, significantly improved the trochanteric pressure sore, as reflected by a NPUAP stage change from III to I, an AHCPR stage change from III to I, and a Braden scale change from 13 to 18. These findings suggest that Korean medicine treatment may be effective to treat pressure sores in stroke patients.