• Title/Summary/Keyword: medullary hemorrhage

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Case of Medullary Hemorrhage with Cavernous Angioma Treated with Oriental Medicine (해면혈관종과 병발한 연수출혈의 한방치료 1례)

  • Kim, Tae Yoon;Baek, In Jyoung;Cho, Hyun Kyoung;Yoo, Ho Ryong;Kim, Yoon Sik;Seol, In Chan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.6
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    • pp.960-963
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    • 2012
  • Cavernous angiomas of the medulla oblongata are rare vascular malformations. We report a case of cavernous angioma with medullary hemorrhage showing symptoms of diplopia and weakness of right extremities. We treated a patient with herb medicine, acupuncture and moxibustion. This study suggests that oriental medicine therapy has a significant effect on the symptoms of medullary hemorrhage.

A Case of Lateral Medullary Infarction after Endovascular Trapping of the Vertebral Artery Dissecting Aneurysm

  • Cho, In-Yang;Hwang, Sung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.160-163
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    • 2012
  • We report an unusual case of lateral medullary infarction after successful embolization of the vertebral artery dissecting aneurysm (VADA). A 49-year-old man who had no noteworthy previous medical history was admitted to our hospital with a severe headache. Computed tomography (CT) revealed a subarachnoid hemorrhage, located in the basal cistern and posterior fossa. Cerebral angiography showed a VADA, that did not involve the origin of the posterior inferior cerebellar artery (PICA). We treated this aneurysm via endovascular trapping of the vertebral artery distal to the PICA. After operation, CT revealed post-hemorrhagic hydrocephalus, which we resolved with a permanent ventriculoperitoneal shunt procedure. Postoperatively, the patient experienced transient mild hoarsness and dysphagia. Magnetic resonance image (MRI) showed a small infarction in the right side of the medulla. The patient recovered well, though he still had some residual symptom of dysphagia at discharge. Such an event is uncommon but can be a major clinical concern. Further investigation to reveal risk factors and/or causative mechanisms for the medullary infarction after successful endovascular trapping of the VADA are sorely needed, to minimize such a complication.

Pontine Necrosis Related with Radiation Therapy, Complicated with Spontaneous Hemorrhage

  • Kim, Ha Min;Hong, Bo Young;Lee, Jong In;Kim, Joon Sung;Lim, Seong Hoon
    • Brain & NeuroRehabilitation
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    • v.10 no.1
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    • pp.1-6
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    • 2017
  • The brain necrosis induced by radiation therapy (RT) is an uncommon pathology of brain. A case of spontaneous hemorrhage at necrotic brain is also rare. A 52-year-old man who had nasopharyngeal carcinoma and had been treated with RT, presented with gait disturbance, dizziness, ataxia, dysarthria, and dysphagia. Magnetic resonance imaging (MRI) demonstrated progressed radiation necrosis of pons, and spontaneous hemorrhage at the site of necrosis. The hematoma was diminished by conservative treatment. However, the patient's neurologic symptoms did not recover. Two years later, spontaneous bleeding recurred at necrotic brain. His neurologic symptoms worsened. One year later, his neurologic symptoms were more progressed. He showed severe dysphagia, profound weakness and respiratory failure. This case provides the description of relapsed spontaneous hemorrhage and medullary dysfunction caused by pontine necrosis and progressed post-radiation injury, complicated with hemorrhage, and urges caution in that the necrotic brain tissue may be vulnerable to bleeding.

Dural Arteriovenous Fistula of Jugular Foramen with Subarachnoid Hemorrhage : Selective Transarterial Embolization

  • Byun, Jun-Soo;Hwang, Sung-Nam;Park, Seung-Won;Nam, Taek-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.199-202
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    • 2009
  • We report the case of a 64-year-old man with dural arteriovenous fistula (DAVF) at right jugular foramen, presented as subarachnoid and intraventricular hemorrhage. The malformation was fed by only the neuromeningeal trunk of the right ascending pharyngeal artery and drained into the right lateral medullary veins craniopetally. Complete embolization was attained by selective transarterial glue injection, but patient showed lower cranial neuropathies. A 3-month follow-up angiogram still showed persistent fistula occlusion. Transarterial glue embolization is a feasible method, only if a transvenous access is not possible in case of single channel fistula.

Endovascular Treatment of Vertebral Artery Dissecting Aneurysms That Cause Subarachnoid Hemorrhage : Consideration of Therapeutic Approaches Relevant to the Angioarchitecture

  • Lim, Seung Hoon;Shin, Hee Sup;Lee, Seung Hwan;Koh, Jun Seok
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.175-183
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    • 2015
  • Objective : Intracranial ruptured vertebral artery dissecting aneurysms (VADAns) are associated with high morbidity and mortality when left untreated due to the high likelihood of rebleeding. The present study aimed to establish an endovascular therapeutic strategy that focuses specifically on the angioarchitecture of ruptured VADAns. Methods : Twenty-three patients with ruptured VADAn received endovascular treatment (EVT) over 7 years. The patient group included 14 women (60.9%) and 9 men (39.1%) between the ages of 39 and 72 years (mean age 54.2 years). Clinical data and radiologic findings were retrospectively analyzed. Results : Four patients had aneurysms on the dominant vertebral artery. Fourteen (61%) aneurysms were located distal to the posterior inferior cerebellar artery (PICA). Six (26%) patients had an extracranial origin of the PICA on the ruptured VA, and 2 patients (9%) had bilateral VADAns. Eighteen patients (78%) were treated with internal coil trapping. Two patients (9%) required an adjunctive bypass procedure. Seven patients (30%) required stent-supported endovascular procedures. Two patients experienced intra-procedural rupture during EVT, one of which was associated with a focal medullary infarction. Two patients (9%) exhibited recanalization of the VADAn during follow-up, which required additional coiling. No recurrent hemorrhage was observed during the follow-up period. Conclusion : EVT of ruptured VADAns based on angioarchitecture is a feasible and effective armamentarium to prevent fatal hemorrhage recurrence with an acceptable low risk of procedural complications. Clinical outcomes depend mainly on the pre-procedural clinical state of the patient. Radiologic follow-up is necessary to prevent hemorrhage recurrence after EVT.

In Situ Intersegmental Anastomosis within a Single Artery for Treatment of an Aneurysm at the Posterior Inferior Cerebellar Artery : Closing Omega Bypass

  • Lee, Sung Ho;Choi, Seok Keun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.467-470
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    • 2015
  • A 74-year-old patient was diagnosed with a subarachnoid hemorrhage suspected from a dissecting aneurysm located at the lateral medullary segment of the posterior inferior cerebellar artery (PICA). Because perforators to the medulla arose both proximal and distal to the dissecting segment, revascularization for distal flow was essential. However, several previously reported methods for anastomosis, such as an occipital artery-PICA bypass or resection with PICA end-to-end anastomosis could not be used. Ultimately, we performed an in situ side-to-side anastomosis of the proximal loop of the PICA with distal caudal loops within a single artery, as a "closing omega," followed by trapping of the dissected segment. The aneurysm was obliterated successfully, with intact patency of the revascularized PICA.

Cytotoxic Effects of Nanoparticles Assessed In Vitro and In Vivo

  • Cha, Kyung-Eun;Myung, Hee-Joon
    • Journal of Microbiology and Biotechnology
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    • v.17 no.9
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    • pp.1573-1578
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    • 2007
  • An increasing number of applications is being developed for the use of nanoparticles in various fields. We investigated possible toxicities of nanoparticles in cell culture and in mice. Nanoparticles tested were Zn (300 nm), Fe (100 nm), and Si (10-20, 40-50, and 90-110 nm). The cell lines used were brain, liver, stomach, and lung from humans. In the presence of nanopaticles, mitochodrial activity decreased zero to 15%. DNA contents decreased zero to 20%, and glutathione production increased zero to 15%. None of them showed a dose dependency. Plasma membrane permeability was not altered by nanoparticles. In the case of Si, different sizes of the nanoparticles did not affect cytotoxicity. The cytotoxicity was also shown to be similar in the presence of micro-sized ($45\;{\mu}m$) Si particles. Organs from mice fed with nanoparticles showed nonspecific hemorrhage, lymphocytic infiltration, and medullary congestion. A treatment with the micro-sized particle showed similar results, suggesting that the acute in vivo toxicity was not altered by nano-sized particles.

Mixed infection with coccidiosis, fowl typhoid and infectious bursal disease in broiler, a case report (육계에서 콕시듐증, 가금티푸스 및 전염성 F낭병 혼합감염 발생 예)

  • 김윤태;고원석;이정원;서이원;양홍지;송희종;오언평
    • Korean Journal of Veterinary Service
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    • v.22 no.1
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    • pp.53-59
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    • 1999
  • In a flocks of broiler, 29 days old, was submitted to Iksan-branch, Livestock Development and Research Institute of Chonbuk province. Grossly, their feathers were ruffled and multiful hemorrhage were presented in the thigh and pectoral muscles. There were multifocal foci on the liver surface and enlarged and edematous on bursa of Fabricius. The coagulative materials, which were blood-tinged, were filled in cecum, and Eimeria oocysts were detected in the cecal contents. Microscopically, macrogametes were noted in the cecum, degeneration and necrosis of lymphocytes in the medullary area of bursal follicles, and multifocal necrosis of hepatocytes. There were positive in the infectious bursal disease(IBD) through selologic test and Salmonella gallinarum were detected. This report is a mixed infection case of coccidium, IBD and fowl typhoid in a flocks of broiler.

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Liver Cirrhosis of Korean Native Goat in Korea : A Case Report (산양의 Liver cirrhosis 발생보고)

  • 민병만;박경애;김환균;조용성;김성열;구찬희;정운익;김홍집
    • Korean Journal of Veterinary Service
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    • v.16 no.1
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    • pp.57-64
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    • 1993
  • This survey was performed to report rare outbreak of liver cirrhosis in Korean native goat (KNG) which was died of Yangpyeong's goat farm on Feb. 1992. The examination for the KNG was carried out by clinical signs, necropsy and various lab-oratory test including parasitic, bacterial and histological test. The KNG looked jaundice, ascite, hemorrhage of lumen, abomasum and intestine, and brownish smooth cirrhotic liver at necropsy. Histological examination for liver revealed considerable proliferation of connective tissue and piecemeal necrosis which was caused by chronic active inflammation in interlobules and intralobules. There were atrophic micro and macro nodules which were sur-rounded by connective tissue. The lobular structure lack almost all central vein. The portal areas appearred proliferation of bile ducts, blood vessels and connective tissues. These connective tissue infiltrated heavily with plasma cells, Iymphocytes and histocytes. Histological examination for brain proved to be hepatic encephalopathy by virture of congestion and edema in cerebral medullary. From these results were demonstrated miked nodular, active, postnecrotic liver cirrhosis.

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Fatal Peritonitis associated with Pasteurella multocida in an Asian Small-Clawed Otter (Aonyx cinereus)

  • Kyung-Seok Na;Hyoung-Seok Yang;Won-Hee Hong;Jae-Hoon Kim
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.54-59
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    • 2024
  • A 12-year-old female small-clawed Asian otter (Anoyx cinereus) with a one-week history of anorexia, chills, and abdominal distension was found dead. Grossly, yellowish-brown turbid fluids accumulated in abdominal cavity of the otter, and yellowish thread-like fibrinous materials were found on the surface of abdominal organs. Several variable sized yellowish-white crystalloids were scattered on the medullary space of kidneys. Histologically, diffuse serositis (peritonitis) characterized by the fibrinous exudates, thickened serosal capsule and the swelling of mesothelial cells were observed in the serosa of liver, spleen, stomach, and intestine. Multifocal necrosis, hemorrhage, infiltration of macrophage, and brown pigments were presented in the liver. Isolated bacteria from ascites and fibrinous materials in abdominal visceral surface were white, smooth and convex with characteristic mousy odor on blood agar plate. These bacteria were confirmed as Pasteurella (P.) multocida type A by polymerase chain reaction analysis. Based on the gross examination, histopathologic findings and bacterial experiments, this otter was diagnosed as severe peritonitis associated with P. multocida and necrotic hepatitis.