• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.511-514
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• 2013

Isolated symptomatic occlusion of the anterior cerebral artery (ACA) is a rare condition and until date, only few cases regarding the revascularization of the ACA have been reported. This paper reports on successful attempt to revascularize the ACA using superficial temporal artery (STA) in patient with isolated symptomatic occlusion of the ACA. A 69-year-old man presented with several episodes of transient weakness involving left lower extremity. Cerebral angiography showed occlusion of the right ACA at the A2 segment. After medical treatment failure, the patient underwent STA-ACA bypass surgery. Subsequent to surgery, there was immediate disappearance of transient ischemic attack and follow-up angiography showed favorable revascularization of the ACA territory. Bypass surgery can be considered in the patients with symptomatic occlusion of the ACA, who have experienced failure in medical treatment.

• Journal of Yeungnam Medical Science
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• v.23 no.1
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• pp.113-117
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• 2006

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that may affect many organ systems including the nervous system. The immune response in patients with SLE can cause inflammation and other damage that can cause significant injury to the arteries and tissues. A 48-year-old woman was admitted to the hospital because of transient monocular blindness. Magnetic resonance imaging and conventional angiography showed severe stenosis of the distal intracranial internal carotid artery. The patient was diagnosed as having SLE but the antiphospholipid antibodies were negative. Amaurosis fugax has not been previously reported as an initial manifestation of SLE in Korea. We report a patient with a retinal transient ischemic attack as the first manifestation of SLE.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.162-168
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• 1990

Unroofed coronary sinus syndrome is an uncommon anomaly which is caused by incomplete formation of the left atriovenous fold and it is usually associated with persistent left superior vena cava. It may be diagnosed by cardiac catheterization and cineangiography but, if it is not diagnosed, it can bring out significant complications due to right to left shunt, such as brain abscess, cerebral embolism, transient ischemic attack, arterial desaturation and there will reduced patient`s life expectancy. Therefore corrective operation was needed. A case of unroofed coronary sinus syndrome which combines with valvular heart disease was experienced at the department of thoracic & cardiovascular surgery of Kosin medical college. The patient was 49 years old female and she complained dyspnea on exertion for 2 yrs. Cardiac catheterization with cineangiography and both superior venacavogram were performed for diagnosis and she was diagnosed as unroofed coronary sinus syndrome combined with mitral and tricuspid regurgitation. Surgical correction was accomplished by reroofing of coronary sinus with pericardial patch, closure of atrial septal defect and annuloplasty of both atrioventricular valves. Postoperative results were satisfactory and course of recovery was uneventful. We report a case of unroofed coronary sinus syndrome with review.

• Endocrinology and Metabolism
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• v.33 no.4
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• pp.429-434
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• 2018

As diagnostic techniques have advanced, primary aldosteronism (PA) has emerged as the most common cause of secondary hypertension. The excess of aldosterone caused by PA resulted in not only cardiovascular complications, including coronary artery disease, myocardial infarction, arrhythmia, and heart failure, but also cerebrovascular complications, such as stroke and transient ischemic attack. Moreover, PA is associated more closely with these conditions than is essential hypertension. In this review, we present up-to-date findings on the association between PA and cerebrovascular diseases.

• Journal of Haehwa Medicine
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• v.22 no.1
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• pp.201-216
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• 2013

The purpose of this case-control study was to show the relationship between risk factor(Sex, Age, Martial Status, Educational Periods, Family history, Variables of Obesity, Smoking Status, Drinking Status, Past History, Blood Test) and the incidence of stroke. Methods: 788 stroke patients were enrolled as the case group and 450 non-stroke patients as control group from Sep.2006 to Dec.2010. Patients were hospitalized within 30 days after the onset of stroke. Risk factors and warning signs were obtained from personal interview by oriental medicine doctors who used CRF. Results: 1. Age was found to have significant relation with stroke(p<.0001). 2. Martial status(p<.0001, OR=0.44) and educational periods(p<.0001) were both significant risk factor for stroke. 3. As a result of reviewing the influence of family history, it was found to have no significant relation with stroke. Stroke was found to have significant relation with stroke(OR=1.50). 4. Female waist circumference(WC, p<.0001) and female waist-hip circumference ratio(WHR, p<.0001) were risk factors for stroke. On the other hand, male WC and male WHR showed no significant influence on stroke occurrence as an independent risk factor. 5. Both smoking status(p<.0001, current smoker OR=8.95) and drinking status(p<.0001, current drinker OR=2.50, former drinker OR=2.82) were significant risk factors for stroke. 6. As a result of reviewing the influence of past history, transient ischemic attack(p<.0001, OR=8.46), hypertension(p<.0001, OR=4.72), hyperlipidemia(0.0064), diabetes mellitus(p<.0001, OR=3.34), stroke(p<.0001, OR=50.26) were significant risk factors. On the other hand, ischemic heart disease(p=0.2332) was found to have no significant relation with stroke. 7. Increase of WBC, RBC, Platelet, TG, FBS and Cl- level were significant risk factor of stroke, On the other hand, decrease of Hgb, Hct, AST, HDL-chol, LDH, Na+ and K+ level were significant risk factor of stroke. T-chol and ALT level showed no significant influence on stroke occurrence.

• Korean Circulation Journal
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• v.48 no.12
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• pp.1148-1156
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• 2018

Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

• Journal of Oriental Neuropsychiatry
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• v.16 no.2
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• pp.287-299
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• 2005

Dissociative disorder is a psychiatric disorder characterized by a sudden loss of memory, but which has no organic disease or explanation. It usually occurs after heavy psychosocial stress or traumatic experience. A transient cerebral ischemic attack (TIA) is an acute episode of temporary and focal loss of cerebral function of vascular origin. TIAs are rapid in onset; symptoms reach their maximal manifestation in fewer than 5 minutes. Manifestations are of variable duration and typically last 2-15 minutes(rarely as long as 24 h). Most TIA durations are less than 1 hour. Of concern is the careful detection of changes in behavior, speech, gait, memory, movement, and vision. TIAs are uncommon in persons younger than 60 years. I treat 6 cases of Sudden Temporary Amnesia Patients with oriental medicine and they are improved. All of them had amnesia for $6{\sim}10\;hours$. During that time, they show behavioral changes and they are not on the state of unconsciousness. After recovery, they also forget what happen at the time. they have some emotional reason too. In conclusion, 4 cases of them belong to dissociative disorder and 2 other cases, TIA.

• Journal of Korean Neurosurgical Society
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• v.50 no.6
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• pp.535-537
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• 2011

Recently, combination of surgery and radiation therapy (RT) has been recommended in the treatment of craniopharyngioma. RT could be associated with late complications, including vasculopathy. We report two cases of the moyamoya syndrome seen in children with craniopharyngioma who received RT after surgical resection. Thirty-five patients in pediatric age with craniopharyngioma were surgically treated. Fifteen out of 35 patients underwent surgical resection followed by RT or gamma knife surgery. Two of the 15 were found to have symptoms of transient ischemic attack and were diagnosed as moyamoya syndrome through the cerebral angiography. Age at RT was 4 and 13 years, respectively. The latent period for development of the moyamoya syndrome was 27 months and 3 years, respectively, after RT. The RT dose of both patients was 54 Gy. These two patients received bilateral encephaloduroarteriosynangiosis procedures. We report here these two cases of radiation-induced moyamoya syndrome in pediatric craniopharyngioma. Pediatric patients with craniopharyngioma who received RT should be reminded, during follow-up, about the risk of development of the moyamoya syndrome.

• Journal of Chest Surgery
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• v.50 no.3
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• pp.220-223
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• 2017

A 71-year-old male with known bronchiectasis and atrial fibrillation was admitted to Seoul St. Mary's Hospital with recurrent transient ischemic attack. R adiofrequency ablation was performed to resolve the patient's atrial fibrillation, but failed. However, a fistula between the left circumflex artery and the bilateral bronchial arteries was found on computed tomography. Fistula ligation and a left-side maze operation were planned due to his recurrent symptom of dizziness, and these procedures were successfully performed. After the operation, the fistula was completely divided and no recurrence of atrial fibrillation took place. A coronary-bronchial artery fistula is a rare anomaly, and can be safely treated by surgical repair.

• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.281-285
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• 2015

Statins lower the hyperlipidemia and reduce the incidence of cardiovascular events and related mortality. A 60-year-old man who was diagnosed with a transient ischemic attack was started on acetyl-L-carnitine, cilostazol, and rosuvastatin. After rosuvastatin treatment for 4 weeks, the patient presented with sudden onset fever, cough, and dyspnea. His symptoms were aggravated despite empirical antibiotic treatment. All infectious pathogens were excluded based on results of culture and polymerase chain reaction of the bronchoscopic wash specimens. Chest radiography showed diffuse ground-glass opacities in both lungs, along with several subpleural ground-glass opacity nodules; and a foamy alveolar macrophage appearance was confirmed on bronchoalveolar lavage. We suspected rosuvastatin-induced lung injury, discontinued rosuvastatin and initiated prednisolone 1 mg/kg tapered over 2weeks. After initiating steroid therapy, his symptoms and radiologic findings significantly improved. We suggest that clinicians should be aware of the potential for rosuvastatin-induced lung injury.