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Rapid Development of Brain Abscess Caused by Streptococcus Pyogenes Following Penetrating Skull Injury via the Ethomoidal Sinus and Lamina Cribrosa

  • Gulsen, Salih;Aydin, Gerilmez;Comert, Serhat;Altinors, Nur
    • Journal of Korean Neurosurgical Society
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    • v.48 no.1
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    • pp.73-78
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    • 2010
  • Objective : Streptococcus pyogenes is a beta-hemolytic bacterium that belongs to Lancefield serogroup A, also known as group A streptococci (GAS). There have been five reported case in terms of PubMed-based search but no reported case of brain abscess caused by Streptococcus pyogenes as a result of penetrating skull injury. We present a patient who suffered from penetrating skull injury that resulted in a brain abscess caused by Streptococcus pyogenes. Methods : The patient was a 12-year-old boy who fell down from his bicycle while cycling and ran into a tree. A wooden stick penetrated his skin below the right lower eyelid and advanced to the cranium. He lost consciousness on the fifth day of the incident and his body temperature was measured as $40^{\circ}C$. While being admitted to our hospital, a cranial computed tomography revealed a frontal cystic mass with a perilesional hypodense zone of edema. There was no capsule formation around the lesion after intravenous contrast injection. Paranasal CT showed a bone defect located between the ethmoidal sinus and lamina cribrosa. Results : Bifrontal craniotomy was performed. The abscess located at the left frontal lobe was drained and the bone defect was repaired. Conclusion : Any penetrating lesion showing a connection between the lamina cribrosa and ethmoidal sinus may result in brain abscess caused by Streptococcus pyogenes. These patients should be treated urgently to repair the defect and drain the abscess with appropriate antibiotic therapy started due to the fulminant course of the brain abscess caused by this microorganism.

A Study on the Effects of Electromagnetic Wave on Human Body - The Variation of Electroencephalogram by Blocking Electromagnetic Wave Materials and Aural Stimuli - (전자파가 인체에 미치는 영향 - 전자파 차폐소재와 청각자극에 나타난 뇌파전위의 변화 -)

  • Lee, Su-Jeong;Lee, Tae-Il
    • Fashion & Textile Research Journal
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    • v.6 no.4
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    • pp.503-510
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    • 2004
  • The study is one of fundamental researches for the development of future smart clothing and textile products with blocking properties from electromagnetic waves by analyzing human physical symptoms in using electromagnetic products in such an environments. Among various textiles in the experiment, nano silver has shown the best blocking performance from electromagnetic waves, which decreases depending on the distance. The power spectrum distribution and the incidence of electroencephalogram between blocking materials and aural stimuli has shown that, ${\beta}$, wave appeared to be active in all channels except for $T_4$, whereas all waves appeared with processed materials and especially with nano silver silk(NSS), ${\alpha}$, ${\beta}$, ${\theta}$, ${\gamma}$ waves appeared active in all regions. As for the brain mapping of ${\alpha}$ wave according to time, there found a strong activity in $P_3$, $P_4$ of the parietal lobe, with all materials on all time regions. With silk nylon metal(SNM) and NSS, it appeared strong in $F_3$, $F_4$ as well. As for ${\beta}$, wave, the activity appeared strong in frontal lobe before 7min. 30sec, where it tends to diminish abruptly in 7min. 30sec. to 13min. 30sec. region. After 13min., it regained gradually. With NSS, it appeared strong in all areas except for the farthest $T_4$. The appearance of ${\nu}$ wave can be deduced as it can affect human body with its toxic property while the silver particles become nano-sized. Therefore, the study conducted with human participants requires a proper particle size of it which would not penetrate cellular tissues and a proper binder and binding treatment for it, to prevent the physical fatigues and the potential diseases. However, it is highly required for back-up researches to verify various aspects in applying nano silver to textile products.

A Case of Penetrating Facial Wound by a Grinder (분쇄기에 의한 얼굴 관통창 1 례)

  • Kang, Jin-ah;Kim, Kang Ho;Paik, Jin Hui;Hong, Dae Young;Kim, Ji Hye;Lee, Kyoung Mi;Kim, Jun Sig;Han, Seung Baik
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.89-92
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    • 2006
  • Penetrating facial wounds are uncommon and are usually life threatening because of the possibility of brain damage. There are three possible pathways for penetrating the cranium through the orbit: via the orbital roof, via the superior orbital fissure, or between the optic canal and lateral wall of the orbit. Brain injuries resulting from the penetrating wounds show extensive parenchymal damage, hemorrhage, and brain edema. Transorbital penetrating wounds can lead to diverse lesions of the optical apparatus, including the eye globe, the optical nerve, and the chiasm. Moreover, intracerebral structures may be hurt, and bleeding and infection may occur. Early diagnosis and prompt debridement are the fundamental factors affecting the outcome of a penetrating facial wound. An 87-year-old man was admitted to the emergency department with a grinder impacted into the medial aspect of the right eye. On presentation, the man was fully conscious with a Glasgow Coma Scale score of 15 and complained of a visual disturbance of the right eye. Computed tomography demonstrated a right orbital medial and inferior wall fracture, a frontal bone fracture, and a contusional hemorrhage in frontal lobe of the brain. A craniotomy with hematoma removal and repair of the orbital floor was done. He showed no neurological deficits except right visual loss. This appears to be the first report of a man with a penetrating facial wound caused by a grinder, who presented with a potentially disastrous craniocerebral injury that did not lead to any serious neurological seguelae.

The Understanding of The Ideomotor Apraxia: Focusing on The Neurological Causes (관념운동실행증의 이해: 신경학적 원인을 중심으로)

  • Shin, Su-Jung;Lee, Joo-Hyun;Park, Jin-Hyuck
    • Therapeutic Science for Rehabilitation
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    • v.4 no.1
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    • pp.19-28
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    • 2015
  • Introduction : The Understanding of neurological lesion relating to apraxia will help to predict symptoms according to a lesion and to establish a proper treatment and goal. So, This study will explain causes and mechanism of a movement error of ideomotor apraxia through literature review and also will suggest the evidence using in treatment. Body : Ideomotor apraxia may occur a damage of the production part in praxis system, and is common in damage of a cortex rater than damage of a subcortex. According to study with gesture, movement of upper limbs is relate of left parietal lobe but finger movement is relate of frontal lobe. The visual and tactile stimulation through using real objects could guide into proper movement aside from memory of a skilled action. Conclusion : Praxis can occur through diverse neurological processing and various external stimulations can help praxis processing. Therefore, the treatment of ideomotor apraxia need to use this stimulations.

Neural Tract Injuries by Penetration of Foreign Body: a Diffusion Tensor Tractography Study

  • Kwon, Hyeok-Gyu;Hong, Ji-Heon;Kwon, Yong-Hyun;Lee, Mi-Young;Kim, Seong-Ho;Jang, Sung-Ho
    • The Journal of Korean Physical Therapy
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    • v.25 no.3
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    • pp.132-135
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    • 2013
  • We presented with a patient who showed injury of the cingulum and fornix by penetration of a foreign body into the brain on diffusion tensor tractography (DTT). A 63-year-old man suffered a brain injury by a part of a power saw blade that was suddenly detached from a power saw during work. A part of the power saw blade penetrated his right frontal skull and advanced to the right posterior horn of the lateral ventricle. This penetration caused traumatic intracerebral hemorrhage in the right frontal lobe and intraventricular hemorrhage in the lateral ventricle. He underwent craniotomy and removal of intracranial foreign bodies (bony pieces and saw blade). The patient's Memory Assessment Scale scores were 74 (4%ile) for global memory, 78 (7%ile) for verbal memory, and 80 (9%ile) for visual memory. DTTs showed disruptions in the anterior portion of the fornical body, right fornical crus, the anterior portion of the right cingulum, and the middle portion of the left cingulum, compared to the control. It seems that the sustained memory impairment of this patient might be related to injury of the cingulum and fornix.

Secondary Intracranial Tumor Associated with Nasal Adenocarcinoma in a Dog: Clinical, Computed Tomography, Magnetic Resonance Imaging, Histopathologic Findings (개에서 발생한 비강샘암종으로부터 유래한 이차성 두개 내 종양 증례)

  • Lee, Jung-Ha;Yoon, Hun-Young;Im, Keum-Soon;Sur, Jung-Hyang;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.30 no.3
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    • pp.206-209
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    • 2013
  • A 12-year-old castrated male Miniature Schnauzer dog was presented with an acute seizure. On computed tomography, a mass was observed in the left nasal cavity and the lysis of the left cribriform plate was identified. Post-contrast magnetic resonance imaging showed a hyperintense mass in the left frontal lobe and hyperintense lesions in the left frontal sinus. The mass was tentatively diagnosed with a brain tumor secondary to a nasal tumor. Histopathology revealed that the mass was a nasal adenocarcinoma with invasion into the brain. This case report describes clinical, computed tomography, magnetic resonance imaging and histopathological findings of secondary intracranial tumor caused by extension of nasal adenocarcinoma in a dog. These findings may contribute to enhance the knowledge on secondary intracranial tumors in dogs.

The Correlation of MRI Findings to Outcome in Diffuse Axonal Injury Patients (미만성 뇌축삭손상 환자의 자기공명영상 소견과 예후와의 상관관계)

  • Oh, Kyung Seup;Ha, Sung Il;Suh, Bumn Suk;Lee, Hyun Sung;Lee, Jong Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.20-24
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    • 2001
  • Object : We intended to investigate the relationship between the degree of injury on MRI and the outcome of the patients with diffuse axonal inury. Method : From january, 1995 to march, 1999, 22 patients were supposed to have diffuse axonal injuries by means of their neurologic signs and MRI. We investigated their prognosis according to CT, MRI and initial neurologic findings. Result : 1) The lesions were mainly located at white matter of cerebrum, corpus callosum, brainstem, and basal ganglia. 2) The lesions of white matter were most commonly in the frontal lobe and temporal lobe. 3) The majority of corpus callosal lesions were located in the posterior body and splenium, but anterior corpus callosal lesions combined with posterior lesions were not found. 4) Brainstem lesions, all non-hemorrhagic, were mostly located in the dorsolateral aspect, not be found on CT. 5) The brainstem lesions were found in 10 cases among total 22 cases, and corpus callosal lesions were accompanied with 8 cases of brainstem lesions. 6) The patients with brainstem lesions had worse prognosis. Conclusion : It is important and reasonable to take brain MRI to identify the brainstem lesions in any cases of suspicious diffuse axonal injury, and we should remind that the diffuse axonal injury with stem lesion has worse prognosis.

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Anatomical Correlates of Neuropsychological Deficits Among Patients With the Cerebellar Stroke

  • Shin, Min A;Park, Oak Tae;Shin, Joon-Ho
    • Annals of Rehabilitation Medicine
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    • v.41 no.6
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    • pp.924-934
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    • 2017
  • Objective To investigate the anatomical correlates of the neuropsychological deficits in patients with the cerebellar stroke. Methods We screened patients who were admitted to the National Rehabilitation Center with the cerebellar stroke between October 2012 and November 2016. The patients with the cerebellar stroke who underwent neuropsychological testing for which the Seoul Neuropsychological Screening Battery (SNSB) or the SNSB-II were enrolled. The neuropsychological function capacities were compared in accordance with the stroke type (hemorrhagic vs. ischemic) and the location (right/left anterior, right/left posterior intermediate, right/left posterior lateral lobe, and vermis). Mean z-scores were computed to compare the patient performances with the population averages. Results Twenty-six patients (15 with ischemic stroke and 11 with hemorrhagic stroke) with a mean age of $54.8{\pm}16.6$ years were assessed $8.8{\pm}9.2$ months after the stroke. Differences in the neuropsychological functioning according to the stroke type were not observed. All of the numerical subtests of the stroke patients showed significantly poorer performances compared with the population averages (mean z-score <0), and some of the subtests revealed abnormal performances in attention-, visuospatial function-, memory-, and frontal/executive function-related tasks (mean z-score <-1). The patients with the presence of a lesion in the right posterior intermediate lobe of the cerebellum showed a poorer performance in the subtests evaluating the executive function including the Korean-version Stroop Test (p=0.04), the Digit Symbol Coding Test (p=0.01), and the Korean-version Trail Making Test (p=0.02) compared with the patients without that lesion. Conclusion The present study confirms that the cerebellar stroke affects the neuropsychological functioning which is associated with the anatomical site of stroke.

Consideration on the Satisfaction of Patients and SUV Variation According to Whether or not to Listen to Music after 18F-FDG Injection (PET/CT 검사에서 18F-FDG 투여 후 음악 청취 여부에 따른 SUV변화와 환자의 만족도에 관한 고찰)

  • Park, Suyoung;Yun, Sunhee;Kim, Hwasan;Kim, Hyunki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.37-43
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    • 2013
  • Purpose: PET/CT scan using the SUV (Standardized Uptake Value) of radiopharmaceutical uptake in organs and tissues as an objective indicator makes it possible to analyze physiological and chemical reactions of human organs. This study analyzes the change of the SUV uptake in accordance with the way how PET/CT patients take a rest after the injection of $^{18}F-FDG$ (Fluororo-deoxyglucose). And also subjective satisfaction is assessed listening to music while taking a rest. Materials and Methods: From April 2011 until February 2013, Among the Primary cancer patients who admitted to the Catholic Medical Center (Seoul & Bucheon St. Mary's Hospital) and scanned $^{18}F-FDG$ PET/CT and also received care through the tracking test (mean age $55.61{\pm}12.41$ years, 108 people, 48 men and 60 women) were selected. The patients were divided into two groups. The first group (A: basal study) is requested to take a rest in bed quietly after the injection. However the second one (B: follow up study) is requested to listen to the music while taking a rest. And then SUV analysis was performed respectively. At the end of the scan, ROI (Region Of Interest) were set from the center of the liver (right lobe) and 3 spots of the brain (frontal, temporal, and occipital lobes). And the SUV was calculated. To identify the correlation among those ROIs, paired t-test was performed using SPSS software (Version 12.0K for windows, P>0.05). Also, after the PET/CT scan the satisfaction study was conducted of all the patients. 1:1 questionnaire survey was performed, and that questionnaire was made using the Likert 5-point scale. By utilizing those questionnaires, the analysis about simple frequency, percentage, average, and standard deviation was performed. Results: The SUV change of the 4 designated ROIs in accordance with listening to music was not statistically significant. (Frontal lobe P-value=0.611, Occipital lobe P-value=0.499, Temporal lobe P-value=0.717, Liver P-value=0.334: P-value>0.05) And the satisfaction study indicated that group B was appear to be 0.42 points (5 basis points) higher than group A. It showed that patients are more satisfied in group B than group A. Conclusion: when performing PET/CT scan using $^{18}F-FDG$, listening to music after the injection of the radiopharmaceuticals does not affect the SUV but given the state of the psychological comfort that may increase the patient's satisfaction.

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Analysis of $^{99m}Tc-ECD$ Brain SPECT Images for ADHD in Children Using Statistical Parametric Mapping (SPM) (주의력 결핍 과잉행동장애(ADHD) 어린이 $^{99m}Tc-ECD$ Brain SPECT Image의 SPM을 이용한 분석)

  • 박성옥;신동호;권수일;이명훈;조철우;윤석남;오은영
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.141-148
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    • 2003
  • The purpose of this study is to evaluate the distribution of clusters and blood flow rate in ADHD SPECT brain blood flow images of children using statistical parametric mapping (SPM99). We studied 64 ADHD children (4-15 y, $8.03{\pm}2.57$ y. male/female:52/12) and compared them with a control group of 12 children (6-l7 y, $9.42{\pm}3.37$ y, male/female:8/4). We injected blood flow tracer $^{99m}Tc$-ethylcysteinate dimer (ECD) as a rCBF agent and took blood flow images after 30 min. by SPECT camera. In the case of hyperperfusion of rCBF in the ADHD group, we found 3 clusters clearly separated at the cingulate gyrus, Rt.cerebral occipital lobe and Lt.cerebellar post. lobe, on probability level 0.05 (P<0.05). Thirty-six ADHD patients with average hyperfusion rates between 18.72-19.30% in each cluster had more increase in blood flow than the average perfusion rate at the Rt. cerebral occipital lobe. These levels were influenced by P-value. In the case of hypoperfusion in the ADHD children, 4 decreased clusters on Lt. and Rt. cerebral frontal lobe, Lt. cerebral claustrum and Rt. cerebral, sup. temporal gyrus at P<0.01 can be seen. The average hypoperfusion rates for the ADHD children were 18.41-18.69% in each cluster, which showed more hypopefusion than the average perfusion rate at the Lt. Cerebrum inf. Frontal gyrus. The perfusion rates and the number of patients were not affected by P-value. The result of this study shows significant hyperpefusion clusters at the probability level of P:0.05 and hypoperfusion clusters at P:0.01. The number of ADHD patients in each clusters and the perfusion rate were not affected by P-value.

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