• Title/Summary/Keyword: Symptoms of Stroke

검색결과 439건 처리시간 0.026초

기관절개술을 시행한 중풍 환자의 객담에 대한 담음(痰飮) 처방 투여 1예(例) (A Case Report of a Tracheostomized Patient with Stroke Suffering from Sputum Secretion Treated with Herbal Prescriptions for dispelling Dam-eum)

  • 권태욱;안립;김명호;이상아;장명웅;최동준
    • 대한한방내과학회지
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    • 제34권3호
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    • pp.329-337
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    • 2013
  • This is a case report of a tracheostomized 80-year-old man suffering from sputum after stroke. His symptoms were watery sputum production requiring frequent sputum suction. The subject was diagnosed as having a deficiency of spleen qi and was treated with Gami-ijung-tang, Yukgunja-tang, Soeumin Bojungikgi-tang, and Ijin-tang extract in the herbal prescription known to dispell Dam-eum (phlegm-retained fluid). Frequency of ssputum suction and condition of sputum were checked everyday. Gamiijung-tang, Soeumin Bojungikgi-tang with Ijin-tang extract led to improvement by reducing sputum secretion. There were limitations on frequency of suction and condition of sputum which were thought to be derived from tracheostomy, however. Consequently, pathology and treatment of sputum will be different whether tracheostomy was performed or not.

The Clinical Outcomes of 75 Consecutive Patients with Cervical Carotid Artery Stenosis Treated by Carotid Artery Stenting

  • Chung, Joon-Ho;Shin, Yong-Sam;Lim, Yong-Cheol;Park, Sang-Kyu
    • Journal of Korean Neurosurgical Society
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    • 제45권6호
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    • pp.350-354
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    • 2009
  • Objective : The purpose of this study was to analyze the clinical outcome of 75 consecutive patients with cervical carotid artery stenosis and who were treated by carotid artery stenting (CAS) only. Methods : From February 2003 to June 2008, there were 78 stents placed in 75 symptomatic patients (mean age : 67.3 years); 69 patients had carotid stenosis ${\geq}70%$, and 6 patients had asymptomatic stenosis ${\geq}80%$. No carotid endarterectomy (CEA) was performed during the same period. The patients were clinically followed-up for a mean of 20.1 months. Results : The procedures were technically successful in all cases. Three (3.8%) patients had procedure-related complications. During the 30-day postprocedural period, there were no restenosis or major stroke. Minor stroke was noticed in 3 (3.8%) patients and 1 (1.3%) of the 75 patients suddenly expired 2 days after discharge. There were no new neurological symptoms that developed during the clinical follow-up period. The results of our series were not inferior to those the previously published in CAS studies, and in fact they were better. Conclusion : Our results suggest that CAS may be safe and useful for the treatment of cervical carotid artery stenosis when it is used as the first line treatment in those institutions that lack enough experience with CEA.

Emergency Carotid Artery Stent Insertion for Acute ICA Occlusion

  • Lee, Hai-Ong;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • 제47권6호
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    • pp.428-432
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    • 2010
  • Objective : An effective intervention has not yet been established for patients with acute occlusion of the internal carotid artery (ICA). The aim of our study was to investigate the feasibility, safety, and efficacy of emergent stent placement of carotid artery to improve neurologic symptoms and clinical outcome. Methods : Of 84 consecutive patients with severe ICA stenosis who were admitted to our institution from March 2006 to May 2009, 10 patients with acute ICA occlusion (11.9%) underwent emergency carotid artery stent placement. We reviewed their records for neurologic outcome using the National Institutes of Health Stroke Scale (NIHSS) score, before and at 7 days after stent placement; clinical outcome using the modified Rankin Scale score (mRS) and Glasgow Outcome Scale (GOS); frequency of procedure-related complications; and recurrence rate of ipsilateral ischemic stroke within 90 days. Results : Carotid lesions were dilated completely in all patients. Median NIHSS scores before emergency stent placement and at 7 days were 16.6 and 6, respectively, showing significant improvement. Eight patients (80%) had favorable outcomes (mRS score 0-2 and GOS 4-5). Complications occurred in two patients (20%): stent insertion failed in one and an intracerebral hemorrhage occurred in the other. Ipsilateral ischemic stroke did not recur within 3 months. Conclusion : Emergency carotid artery stent placement can improve the 7-day neurologic outcome and the 90-day clinical outcome in selected patients with acute cerebral infarction.

COVID-19 후각 이상에 대한 한의학적 고찰 (Olfactory Dysfunction in COVID-19 from a Korean Medical Perspective)

  • 김상현;김종현
    • 대한한의학원전학회지
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    • 제35권2호
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    • pp.99-120
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    • 2022
  • Objectives : To analyze symptoms of olfactory dysfunction caused by COVID-19 from a Korean Medical Perspective. Methods : Previous studies dealing with olfactory dysfunction accompanying COVID-19 were studied and analyzed for general characterization. Physiology and pathology of olfactory functions within the classical texts of Korean Medicine were collected and analyzed, through which symptoms of olfactory dysfunction in COVID-19 were examined. Results : Olfactory dysfunction manifested in high ratios in the early stages of confirmed COVID-19 cases, at times independent of other nasal symptoms such as blockage or discharge. There was a high chance of loss of taste being accompanied, while mental problems such as a tendency to have difficulty concentrating were present as well. In most cases, recovery took one to two weeks. From a Korean Medical perspective, physiology of olfactory function is closely linked to the Lungs, Ancetral Qi[宗氣], and the Heart, while its dysfunction could be explained by pathological factors such as Wind-Cold, Fire stagnation, Qi deficiency, Wind stroke, etc. Conclusions : In the context of external contraction disease[外感病], olfactory dysfunction could be caused by problems in the Lungs and Stomach that are responsible for breathing, or the Heart which is involved in recognizing and differentiating scent. General characteristics of COVID-19 imply it to be closely related to the Heart. In clinical application, overall symptoms need to be considered in diagnosis and treatment planning, after which further approaches could made to determine the problem to be of the Lung and Stomach, or of the Heart.

『동의보감(東醫寶鑑)』에서 숙지황(熟地黃), 천궁(川芎), 당귀(當歸), 백작약(白芍藥)이 군약으로 사용된 방제의 주치병증 비교 (A Study of Disease Prescription Using Rehmannia glutinosa, Cnidium officinale, Angelica gigas, Paeonia lactiflora in Dongeuibogam)

  • 금유정;송시훈;이병욱;송지청
    • 한국의사학회지
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    • 제34권2호
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    • pp.89-96
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    • 2021
  • This research aims to find a way to utilize the literature to select the herbs to be added or subtracted according to the condition of the patient after determining the basic prescription to be used for the patient. The study is based on data concerning the herbal composition and application of prescriptions described in the Donguibogam. The composition herbs was expressed as a weight ratio, the standard deviation of the weight ratio was calculated for each prescription, and the case where the weight ratio was greater than the base value (highest weight ratio - standard deviation) was designated as a principal herb. The various expressions of applications were changed to representative terms by the researcher and used to calculate the frequency. Of the 4,373 prescriptions for Donguibogam, 3,307 were able to be expressed in terms of weight ratios with 640 prescriptions using Rehmannia glutinosa, Cnidium officinale, Angelica gigas and Paeonia lactiflora as the principle herb. Of the 640 prescriptions, 508 prescriptions included applied information. Rehmannia glutinosa can also be used for symptoms such as fetal leakage(胎漏), short ingestion(食少), fever(發熱), dazed expression(眼花). Cnidium officinale can also be used for symptoms such as migraine(偏頭痛), stroke(中風癱瘓), tetanus(破傷風). Angelica gigas can also be used for symptoms such as forgetfulness(健忘), incontinence of urination(小便不通), palpitations(驚悸). Paeonia lactiflora can also be used for symptoms such as heart pain and abdominal pain(心腹痛), cough(咳嗽).

지역사회 뇌졸중 환자들의 이차 예방을 위한 치료 지속률과 약물 순응도 관련 요인 (Predictors of Persistence and Adherence with Secondary Preventive Medication in Stroke Patients)

  • 김영택;박기수;배상근
    • 농촌의학ㆍ지역보건
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    • 제40권1호
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    • pp.9-20
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    • 2015
  • 지역사회 뇌졸중환자들의 치료 지속률과 약물 순응도에 대한 연구는 아직 많이 실시되지 않았다. 그러나 치료 지속률과 약물 순응도가 뇌졸중의 재발 및 사망과 밀접한 관련이 있다는 것은 많이 알려진 사실이다. 이에 본 연구는 지역에 거주하고 있는 뇌졸중환자들을 임의 추출하여 이들의 치료 지속률과 약물 순응도를 평가하고 이에 영향을 미치는 요인을 찾기 위하여 실시되었다. 연구대상자는 429명으로 이들의 뇌졸중 치료율과 현재 복용하고 있는 약물의 순응률을 파악하였으며 약물 순응도는 의도적 비순응군과 비의도적 비순응군으로 구분하여 조사하였다. 연구 결과 치료 지속률은 86.5%였으며 이들 중 약물 순응도는 41.2%였다. 치료 지속률에 영향을 미치는 요인으로는 보건교육 경험뿐이었으며, 비의도적 약물 비순응에 영향을 미치는 요인은 mRS와 보건교육 경험 그리고 의도적 약물 비순응에 영향을 미치는 요인은 mRS와 우울감 정도 그리고 약물에 대한 신념(필요성, 염려)이었다. 결론적으로 지역사회 뇌졸중환자의 재발방지와 사망률감소를 위하여 약물복용을 중요하게 교육하여야 할 것이며 순응도 향상을 위해서는 약물에 대한 필요성은 올리고 염려 수준을 낮추도록 교육하여야 할 것이다.

좌측 정중 전두엽과 양측 기저절 경색 후 과잉성욕 증상과 강박 증상을 보인 환자 1례 (A Case Report : Hypersexuality and Obsessive-Compulsive Behaviors in a Stroke Patient with the Left Mesial Frontal Cortex and Both Basal Ganglia Lesion)

  • 김세주;김영신;최낙경;이병철;이만홍
    • 생물정신의학
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    • 제8권2호
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    • pp.271-275
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    • 2001
  • 60세 남자 환자로 좌측 정중 전두엽과 양측 기저절 경색 후 발생한 과잉성욕 증상과 강박 증상을 주소로 내원하였다. 환자는 뇌졸중 후에 발생한 운동 기능 장애는 시간이 경과하면서 호전되어 발병 1개월 이내에 거의 정상화된 반면 과잉성욕 증상과 강박 증상은 호전되지 않았다. 환자에게 과잉성욕 증상과 강박 증상을 목표로 fluvoxamine과 perphenazine을 처방하였으며 치료 시작 후 2개월이 경과하면서 환자의 과잉성욕 증상과 강박 증상은 서서히 사라졌다. 이 증례는 기저절-시상전두엽 회로가 성적 행동과 강박 증상의 조절에 있어 중요한 역할을 하고 있음을 시사한다고 할 수 있다. 과잉성욕 증상은 임상에서 간과하기 쉽고 또한 일반적으로 성적 활동에 대한 변화는 환자들 스스로 보고하지 않는 경향이 많다. 따라서 뇌졸중 환자, 특히 정중 전두엽이나 기저절 병변을 동반한 환자들의 경우에는 비록 그 병변이 측두엽 침범이 없거나 Kluver-Bucy syndrome의 전형적인 증상을 보이지 않는다 할 지라도 성욕등 성적 활동에 대한 체계적인 조사가 필요할 것으로 생각된다. 또한 과잉성욕 증상과 강박 증상을 함께 가지고 있는 경우 선택적인 세로토닌 재흡수 억제제의 사용이 두 증상 모두를 효과적으로 치료하는 데에 도움이 될 수 있을 것이다.

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뇌졸중 환자의 지역사회중심재활서비스: 사례연구 (The Service of Community-Based Rehabilitation in Stroke Patient: A Case Study)

  • 김지현
    • 대한지역사회작업치료학회지
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    • 제1권2호
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    • pp.31-43
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    • 2011
  • 목적 : 지역사회에 거주하는 뇌졸중 환자를 대상으로 사례연구를 통해 지역사회중심재활서비스에 대한 소개와 중재 결과를 제시하고자 하였다. 연구방법 : 지난 2009년 7월 처음 내소한 63세 여성 뇌졸중 환자 1명을 대상으로 지역사회중심 재활서비스를 제공하였다. 대상자의 일상생활동작수준을 평가하기 위해 수정바델지수(Modified Barthel Index; MBI)를 이용하였고, 우울정도를 측정하기 위해 Beck 우울척도(Beck Depression Inventory; BDI)를 사용하였다. 중재 기간은 2011년 4월 27일부터 2011년 11월 30일까지로 세계보건기구에서 제안한 지역사회중심재활서비스와 일반적 작업치료를 제공하였다. 결과 : 환자의 MBI는 35점에서 55점으로 일상생활수행능력이 증가하였고, BDI는 26점에서 14점으로 우울증세가 큰 폭으로 감소한 것을 확인하였다. 초기 5~10분이던 서기 훈련이 30분 이상으로 늘어난 것으로 보아 근력 및 근지구력도 증가하였다. 치료시간에 환자의 기분변화가 심했던 이전과 달리 안정되고 웃는 모습을 자주 볼 수 있었다. 보호자 역시 환자가 심리적으로 안정된 상태를 체감할 수 있었다. 결론 : 지역사회로 복귀한 만성 뇌졸중 환자에게 지역사회중심재활서비스를 적용하여 기능수준 및 삶의 만족도가 향상된 것을 알 수 있었다.

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푸셔 증후군이 있는 뇌졸중 환자에서 시각적 피드백기반 로봇보조 재활치료의 효과 (Effect of Robot Assisted Rehabilitation Based on Visual Feedback in Post Stroke Pusher Syndrome)

  • 김민수
    • 한국산학기술학회논문지
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    • 제17권10호
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    • pp.562-568
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    • 2016
  • 본 연구의 목적은 가상현실과 로봇보조재활치료를 이용하여 뇌졸중 후 푸셔 증후군에 대한 치료적인 효과를 조사하고자 하기 위함이다. 총 10명의 뇌졸중 후 푸셔 증후군을 보이는 환자가 모집되었다. 환자는 각각 5 명씩 로봇보조재활치료와 대조군으로 배정되었다. 실험군은 로봇보조재활치료와 일반적인 재활치료를 함께 받았으며, 대조군은 하루 2회 일반적인 재활치료를 받았다. 중재 시간은 30분간 진행되었으며, 주 5회, 4주간 시행하였다. 치료 전후 변화는 Scale for contraversive pushing (SCP), Berg balance scale (BBS), falling index (FI), Timed up and go test (TUG)을 이용하여 측정하였다. 4 주간의 중재 치료 후 로봇보조재활치료 군에서 SCP (p=0.046), BBS (p=0.046), FI (p=0.038), TUG (p=0.038)은 대조군에 비하여 유의하게 향상되었다. 또한 SCP와 BBS (p=0.024), FI (p=0.039), TUG (p=0.030)는 유의한 상관관계가 관찰되었다. 결과적으로 가상현실을 이용한 로봇보조재활치료는 일반적인 재활치료에 비하여 뇌졸중 후 푸셔 증후군을 회복하는데 더 도움이 되었으며, 푸셔 증후군의 회복은 균형과 보행기능의 향상과 관련이 있었다.

Bilateral Medial Medullary Infarction (Dejerene Syndrome) Patient Suffering from Quadriplegia Treated by Korean Traditional Medicine: a Case Report

  • Lee, Yoo-na;An, Yu-min;Baek, Kyungmin;Jang, Woo-seok
    • 대한한방내과학회지
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    • 제41권5호
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    • pp.902-910
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    • 2020
  • Medial medullary infarction, with representing symptoms of hemiparesis, lingual palsy, and sensory defect, usually has a bad prognosis. The present case is unusual as the patient had a bilateral infarction, and little information is available for bilateral cases. We treated a patient diagnosed with bilateral medial medullary infarction with the symptoms of quadriplegia, lingual palsy, dyspnea, dysphagia, spastic pain, and loss of proprioception. After 126 days of traditional Korean medicine treatment, the patient showed increased muscle power, sensory recovery, reduced spastic pain, and alleviation of dysphagia and dyspnea. This report indicates that traditional Korean medicine could be an effective treatment of the sequelae of medullary infarctions.