• Title/Summary/Keyword: Stroke sequelae

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Depression and Executive Dysfunction in Stroke (뇌졸중에서 우울증과 실행기능부전에 대한 고찰)

  • Na, Kyoung-Sae;Kim, Shin-Gyeom;Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.19 no.4
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    • pp.179-186
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    • 2012
  • Depression and executive dysfunction are common neuropsychiatric sequelae of stroke. Patients with stroke are more predisposed to depression and executive dysfunction compared to patients with similar degree of physical disability. Both depression and executive dysfunction are also associated with poor prognosis such as high mortality and delayed recovery after stroke. Complex neurobiological and anatomical mechanisms are associated with the development of depression and executive dysfunction after stroke. Activation of pro-inflammatory cytokines is thought to be associated with onset of depression, whereas injuries in frontal-subcortical circuit are thought to be a link between depression and executive dysfunction. Early detection of depressive symptoms and both pharmacological and non-pharmacological treatment would be helpful. In this review paper, the authors investigated 1) biological and neuroanatomical substrate for poststroke depression and executive dysfunction, 2) the relationship and common etiopathology for poststroke depression and executive dysfunction, and 3) pharmacological and non-pharmacological treatment for poststroke depression. The contents of the paper are as follows : the prevalence, clinical manifestation, and biological etiology for poststroke depression, neuroanatomical abnormalities as a common etiological factor for depression and executive dysfunction, pharmacotherapy and non-pharmacological approach.

The Effect of Defecation on Blood Pressure in Stroke Patients (배편이 중풍 환자의 혈압에 미치는 영향)

  • 이태호;신정애;이영구;윤희식
    • The Journal of Korean Medicine
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    • v.24 no.1
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    • pp.181-189
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    • 2003
  • Background : Patient, family, society and country are badly damaged by stroke (CVA : cerebrovascular accident). To reduce sequelae and return rapidly to society, treatment in the acute stage is very important. In many studies on purgation therapy (下法) used in acute stages of stroke, the changes of blood pressure, pulse and so on before and after purgation therapy were reported. However, the changes in the human body according to the day elapsed after defecation were not reported, so study was needed to confirm such changes. Methods : Seventy-six patients were studied. We observed forty-three patients at acute stroke and thirty-three patients at convalescent stroke. To confirm the importance of regular defecation in stroke patients, we analyzed blood pressure according to the day elapsed after defecation. Results : The following result were obtained. 1. In stroke group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute stroke group. 2. Especially in stroke and acute stroke groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. 3. In the infarction group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute infarction group. 4. Especially, in the infarction and acute infarction groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. Conclusion : In stroke patients, regular defecation is important, so we think that purgation therapy (下法) is needed in stroke patients over the third day elapsed after defecation. We think that the bowel movement control in acute stroke patients is more important than in convalescent stroke patients.

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Patients' Lived Experience in Rehabilitating from Stroke (뇌졸중 환자의 재활 경험)

  • Lee, Young-Ae
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.1
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    • pp.20-30
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    • 2001
  • Stroke is known as a detrimental disease that leaves serious sequelae. The stroke patients suffer from limitations of physical and social activities. The patients try to adapt themselves to the limitations in order to achieve rehabilitation. This study was performed to clarify the lived experience of rehabilitation from the stroke patients. In collecting data for this study, in-depth personal interviews were made by a researcher from February to April in 2001 at rehabilitation clinics and physical therapy centers locate in Iksan city. The methodological approach was van Manen's hermeneutic phenomenological methodology in order to understand the meaning and nature of stroke patients' experiences in rehabilitating their physical limitations. Collected data were analyzed with phenomenological way of study that was develope by van Manen. The 8 patients who agreed to participate in this research were inter viewed by researcher under the private and comfortable environment. Personal interviews were done three or five times per each patients and each interview took 70 to 90 minutes. The statements were analyzed and finally revealed three essential themes : Theme 1 - Desperateness to achieve freedom again Theme 2 - Seizing hope of recovering Theme 3 - Seeking support from family members, relatives and friends Based on these themes, stroke patients' rehabilitation experience are described as following. The stroke patients have strong desire to achieve freedom again in order to escape from social isolation. The stroke patients want to go back to the state of their previous health state. The stroke patients strongly try to do anything for their recovering and also to have positive thinking. In the other hand, they feel pity for themselves through desperation, fear, sorrow, and self-pity. The stroke patients have dissatisfaction about neighbors' rumor and attitude toward themselves. The stroke patients have experiences to rely on neighbors' support seeking a warm word of consolation. This research showed us that van Manen's hermeneutic phenomenological methodology leads us to understand stroke patients' rehabilitation process more comprehensibly. Based on this research, it is suggested that further studies provide a foundation for the development of a rehabilitation theory for Korean stroke patients.

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Neuroprotective Effect of Ginseng radix on ICH-induced Rats

  • Jang, Kwan-Ho;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Korean Medicine
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    • v.26 no.4
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    • pp.87-97
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    • 2005
  • Backgrounds: Intracerebral hemon-hage is one of the most devastating types of stroke. Ginseng radix, the root of Panax Ginseng, C. A. MEYER (Araliaceae), is one of the most famous medicinal herbs with various therapeutic applications. Objectives: In the present study, the effect of aqueous extract of Ginseng radix on intracerebral hemorrhage-induced neuronal cell death in rats was investigated. Materials and Methods: Step-down avoidance task, Nissl staining, immunohistochemistry for caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay were used for this study. Results: The present results show that hemorrhage-induced lesion volume and apoptotic neuronal cell death in the striatum were significantly suppressed by treatment with Ginseng radix, resulting in enhancement of short-ten-n memory. Conclusions: We have shown that Ginseng radix has a neuroprotective effect on stroke, and aids the recovery from central nervous system sequelae following stroke.

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Two Cases of Motor Impairment after Cerebrovascular Disease by Jihwangeumja (중풍 후 운동장애에 대한 지황음자(地黃飮子) 투여 2례)

  • Hong, Gwang-Hae;Lee, Hyun-Ju;Hwang, Kyu-Dong
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.9 no.1
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    • pp.46-53
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    • 2008
  • Cerebrovascular disease causes various symptoms like hemiparalysis, facial palsy, dysphagia, dysphasia etc. Although patients take lots of time to treatment, there are many cases symptoms could not be cured completely and patients could get sequelae. Jihwangeumja(dihuangyinzi) is used the cerebrovascular disease with dysphasia and motor impairment of the lower extremities due to weakness of kidney. The purpose of this study was to investigate the effect of Jihwangeumja on lower extremity weakness caught by cerebrovascular disease. In this study, we administered Jihwangeumja to two stroke patients with lower extremity weakness and analyzed the clinical progresses. As a result of the treatment, patients showed improved symptoms.

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Effectiveness of Bee Venom Acupuncture on Shoulder Pain after Stroke (뇌졸중 환자의 견관절 통증에 대한 봉독약침의 임상효과)

  • Ko, Chang-Nam;Park, Sung-Wook;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Min, In-Kyu
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.11-24
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    • 2007
  • Objectives : Hemiplegic shoulder pain is one of the common sequelae of stroke. Although many different methods of treatment are applied, none have yet been proved to be effective. In this study we assessed the effectiveness of bee venom in patients with shoulder pain after stroke. Methods : This study was a double blinded, randomized, placebo-controlled clinical trial. All subjects received either 0.6 ml bee venom injection (venom:saline = 1:10000) or 0.6ml physiological saline solution (placebo) at three acupoints. The effectiveness was assessed by visual analogue scale, pain rating score, Fugl-Meyer assessment and passive external rotation. Results : There were 24 patients in the venom group and 22 patients in the placebo group. The venom group5,hewed more effectiveness in VAS and PRS than the placebo group. Conclusions : This study suggests that bee venom injection has significant analgesic effect on hemiplegic shoulder pain. Further study based on multi-centers, larger population, and long term 1311ow-up is needed to confirm this suggestion.

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Two cases of Ukgansan-gami on Sleep-related Behavior Disorder after Stroke (뇌졸중 이후 수면관련 행동장애를 보이는 환자에 대한 억간산가미 치험 2례)

  • Kim, Soohyun;Lee, Yu Jin;Yang, Jung-yun;Cho, Ki-Ho;Moon, Sang-Kwan;Jung, Woo-Sang;Kwon, Seungwon;Jin, Chul
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.20 no.1
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    • pp.9-16
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    • 2019
  • ■ Objectives This case study is to report the two cases of Ukgansan-gami on sleep-related behavior disorder after stroke. ■ Methods Two patients who had sleep-related behavior disorder after stroke were treated by Ukgansan-gami about a month. We evaluated these patients with the frequency and severity of symptoms. ■ Results During treatment period, decreases in both frequency and severity of symptoms were observed in two cases. ■ Conclusion Two patients who were suffered from sleep-related behavior disorder due to sequelae of stroke showed significant improvement of their symptom after taking Ukgansan-gami.

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A Case Report of the Poststroke Seizure (뇌졸중 후유증으로 나타나는 간질환자 치험 1례)

  • Yi, Jung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.1
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    • pp.27-33
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    • 2006
  • Objectives : This report is about a case of a patient who improvement in general condition, Infection and dysphagia after poststroke seizure. Methods : We observed a patiet who received treatment in hospital because of stroke sequelae. Her symptoms were left hemiplegia, right hemiparesis, dysphagia, dyspnea, sputum and general weakness, and acupunture and herb medicine were applied. Results : Stroke is the most common cause of seizures in the elderly. The impact of late onset GTC(generalized tonic-clonic) seizures is associated with worse outcomes. Conclusion : The patient of this case was attacked by intracerebal hemorrhage, cerebaral infarction and GTC seizures. Since then her neurologic disorder was progressed. As the treatments of the patient, herb medication and acupuncture therapy were applied and she got a wide improvement of dysphagia, dyspnea, URI sign and general condition.

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The Effects of Community based Self-help Management Program on the Activity of Daily Life, Muscle Strength, Depression and Life Satisfaction of Post-stroke Patients (재가 뇌졸중 환자를 위한 자조관리프로그램이 일상활동, 근육 강도, 우울 및 삶의 만족도에 미치는 효과)

  • Kim, Keum-Sun;Seo, Hyun-Mi;Kang, Ji-Yean
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.1
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    • pp.108-117
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    • 2000
  • Stroke is one of the leading causes of death in Korea. Because of their sequelae, strokes are categorized as a sudden-onset, constant course chronic illness which needs continuous efforts for rehabilitation. Unfortunately, there are few community based rehabilitation program for post-stroke patients who stay at home. The authors developed a community based selp-help management program for post-stroke patients to enhance their rehabilitation process. The program consists of five sessions and each session contains health education. ROM exercise, ADL training, and stress management like foot reflexology. A professor and two graduate students of nursing college coordinated the program. To test the effects of the program we conducted a 5 week program to the 10 conveniently selected post-stroke patients who were living in Kang-buk district of Seoul. The Questionnaires about ADLs, IADLs, depression and life satisfaction were asked to the all subjects before and after program. The hand grisp power and muscle strength of four limbs were measured at the end of each sessions. The analysis of data revealed that the program was effective to increase the ADLs, IADLs, and muscle strength and to decrease the depression levels of subjects. However, there was no significant difference between pre and post hand grisp power and life satisfaction. Because the program was effective to Improve the physical and psycholocial function of subjects, we suggest continual development and Implementation of community based self-help management programs.

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A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine (사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰)

  • Oh, Hyunjoo;Lee, Jeongyun;Lee, Hyeri;Lee, Junhee
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.2
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    • pp.48-64
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    • 2022
  • Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.