• 동의신경정신과학회지
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• 제11권2호
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• pp.103-111
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• 2000

Objectives : We studied the aspects of headache in the patients with stroke. We compared character of headache on stroke with functional one. Methods : The subject of this study was based on 63 patients with headache who were admitted to the oriental hospital after stroke. We analyzed patients into sex & age, month, severity of headache on stroke type & lesion, site & character of headache. associated symptoms & signs on headache state.Results : The age of headache with stroke is higher than general headache. There was significant differences between general headache and headache with stroke. The cerebral hemorrhage is severer than cerebral infaction in th pain of headache. The most frequently appeared site of headache is temporal area and associated symptoms is vertigo & nausea.Conclusions : The headache of stroke patient is different form functional headache. because of cerebral vascular accident influence on inducing headache. Therefore we should study different methods between the headache of stroke patient and the others in medical treatment.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.84-87
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• 2006

The MELAS (Mitochondrial Encephalomyopathy with Lactic Acidosis, and Stroke-like episodes) syndrome is one of the inherited mitochondrial disorder. We have experienced a 16-year-old girl with headaches and left hemianopsia. Diagnosis of MELAS syndrome with multiple brain parenchymal lesions was confirmed by gene study. The stroke-like lesion of MELAS syndrome showed significant improvement in radiological follow up study. Therefore, MRI findings in MELAS could be interpreted as metabolic cellular dysfunction rather than ischemic vasculopathy.

• Investigative Magnetic Resonance Imaging
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• 제22권2호
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• pp.131-134
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• 2018

Susceptibility-weighted imaging (SWI) is well known for detecting the presence of hemorrhagic transformation, microbleeds and the susceptibility of vessel signs in acute ischemic stroke. But in some cases, it can provide the tissue perfusion state as well. We describe a case of a patient with hyperacute ischemic infarction that had a slightly hypodense, patchy lesion at the left thalamus on the initial SWI, with a left proximal posterior cerebral artery occlusion on a magnetic resonance (MR) angiography and delayed time-to-peak on an MR perfusion performed two hours after symptom onset. No obvious abnormal signals at any intensity were found on the initial diffusion-weighted imaging (DWI). On a follow-up MR image (MRI), an acute ischemic infarction was seen on DWI, which is the same location as the lesion on SWI. The hypointensity on the initial SWI reflects the susceptibility artifact caused by an increased deoxyhemoglobin in the affected tissue and vessels, which reflects the hypoperfusion state due to decreasing arterial flow. It precedes the signal change on DWI that reflects a cytotoxic edema. This case highlights that, in some hyperacute stages of ischemic stroke, hypointensity on an SWI may be a finding before the hyperintensity is seen on a DWI.

• 대한음성학회:학술대회논문집
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• 대한음성학회 2005년도 추계 학술대회 발표논문집
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• pp.127-130
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• 2005

Foreign Accent syndrome refers to segmental and suprasegmental changes of speech characteristics following brain lesion which is perceived by listeners as a foreign accent. Change in dialect after a stroke, however, have rarely been reported. We describe a patient who showed prominent change of accent from one to another Korean dialect and discuss about the alteration of prosodic patterns and the changes in segmental level of speech.

• 한국전문물리치료학회지
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• 제10권3호
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• pp.41-51
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• 2003

The purpose of this study was to examine the effects of stroke patients' cognitive score on their the activities of daily living. The subjects of this study were 30 stroke patients who were admitted to T$\breve{a}$e-Bong hospital from November, 2002 to March, 2003. The subjects were administerd an MMSE as a cognitive assessment and an MBI as a functional assessment upon referral to physical therapy initially. The results were as follows: 1. The MMSE scores for the stroke patients were related to the patients' abilities to perform their activities of daily living. The changes of MBl scores significantly correlated with the changes of MMSE scores (p<.05). 2. The subjects with left hemispheric lesion scored higher in MMSE than those with right hemispheric lesions (p<.05). 3. The hemispheric lesions did not significantly affect the activities of daily living score (p>.05).

• 대한한방내과학회지
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• 제28권1호
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• pp.47-67
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• 2007

Objectives : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : 225 acute stroke patients were recruited at the Department of Cardiovascular and Neurologic Diseases (Stroke Center) of Kyung Hee University Oriental Hospital from October 2005 to September 2006. We evaluated their stroke type with brain MRI, their warning signs, and general characteristics such as age, sex, past history, risk factors, etc. Results : 225 subjects were included in the final analysis. In the subjects' general characteristics, the most common etiology of stroke was small vessel occlusion. In the assessment of the subjects' warning signs, the frequency of tension felt at the cervical area was highest followed by blepharospasm, sensory dysfunction (one side of numbness, tingling sensation, dead sensation), one side paralysis or weakness, etc. After analyzing etiology, cerebral hemorrhage had more facial spasm sign and hypertension than cerebral infarction. On the other hand, cerebral infarction had more diabetes and sensory dysfunction (one side of numbness, tingling sensation, dead sensation) than cerebral hemorrhage. Among stroke locations, subjects with their brain lesion in the cortex had more warning sings of motor dysfunction such as one side paralysis, or weakness. Multiple lesions showed a close relationship with smoking habit and were more common in males than in females. The under 65 years old group were more commonly associated with alcohol consumption, accidental mental stress and blepharospam than the over 65 years old group. In the group of under 65 years old, males more commonly had lesions in occipital lobe, alcohol consumption and smoking habit than females. Otherwise, females more commonly had vision dysfunction and blepharospasm than males. In the group of over 65 years old, males more commonly had cortex lesion than females. On the other hand, Females more commonly had accidental mental stress than males. Conclusions : We observed various warning signs and their distribution in acute stroke patients. The subjects' brainlesions and their etiology seemed to affect the features of the warning signs. Hypertension, diabetes and hyperlipidemia were also related to etiology of stroke and some habitual problems such as smoking and drinking seemed to reduce the age of stroke ictus. Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which appear among their patients.

• 대한한의학회지
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• 제21권4호
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• pp.104-111
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• 2000

Objectives: When stroke occurs, Korean people usually hope to be treated by traditional therapy and to be admitted to an oriental hospital. So this observation was done to make a small contribution toward stroke studies at oriental hospitals. Methods: This observation was made on 189 cases of stroke patients who were admitted to Kang Nam oriental medicine Hospital of Kyung Hee University from May, 1999 to August, 2000. Results and Conclusions : 1. The incidence of cerebral infarction was 3.6 times that of cerebral hemorrhage. 2. The incidence in females was 1.25 times of that in males. The incidence of stroke increased with aging and more cerebral hemorrhage occurred in lower age group than cerebral infarction. 3. There was higher morbidity in October and May, during the changing of the seasons, than any other months. 4. Hypertension the most common preceding disease, followed by heart disease, diabetes mellitus, hyperlipidemia. 5. Alcohol was the highest risk factor, followed by smoking, then obesity. 6. In cerebral infarction, MCA territory was the most frequent lesion site. 7. The change of Modefied Bathel Index(MBI) between MCA territory and others in cerebral infarction had no significance for 4weeks.(P>0.05)

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.128-135
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• 2001

Background : Tremor is uncommon manifestation of stroke. Therefore a few cases have been reported until now. There is still uncertainty about the characteristics of post-stroke tremor. Furthermore the pathogenesis and responsible structures of post-stroke tremor are not precisely known. We have recently experienced 34 cases of post-stroke tremor for the past 6 years. We analysed the clinical features and electrophysiologic findings of post-stroke tremor to evaluate the general characteristics and to analogize the possible pathogenetic mechanisms of post-stroke tremor. Methods : The clinical characteristics of post-stroke tremor were summarized in according to the onset time, involved body parts, types, tremor frequencies, neuroradiologic findings, and associated symptoms. The tremor frequencies were recorded by using a gyroscope. The spectral analysis of tremor frequencies were done automatically with Motus I soft ware. Results : Tremor onset were remarkably varied. Some patients showed a tremor appearing at the onset of a stroke and other patients showed delayed-onset tremor 10 years after a stroke. Tremor frequencies were also much varied. The range of hand tremor frequencies were from 1.5 to 12 Hz. Lesions were found in 31 cases(infarction 27, hemorrhage 4) on neuroimaging. In the cases of cerebral infarctions, 7 cases showed multiple small vessel diseases and 20 cases showed cerebral vessel lesions. The most commonly involved cerebral vessel lesion was the middle cerebral artery territory Several different clinical patterns of post-stroke tremor were identified. Conclusions : There are some evidences from the data summarized here to suggest that several pathogenetic mechanisms including central oscillators could be involved for the development of tremors and that tremor generating neural circuits could be more complex than previously suggested neural circuits.

• Annals of Clinical Neurophysiology
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• 제14권2호
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• pp.64-71
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• 2012

Background: It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) function by the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMN after UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability properties of the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitability test (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motor axons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during the acute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration-charge curve, parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and the recovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group, significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stage of stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in ('fanning in') of the TE was found. Conclusions: Our results suggest that supratentorial brain lesions can affect peripheral axonal excitability even during the early stage. The NET pattern probably suggests background membrane depolarization of LMNs. These features could be associated with trans-synaptic regulation of UMNs to LMNs as one of the "neural plasticity" mechanisms in acute brain injury.

• 대한한방내과학회지
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• 제23권1호
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• pp.1-4
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• 2002

Objective : Hyperhomocysteinemia has been proven to be an independent risk factor for stroke. The genetic mutation of methylenetetrahydrofolate reductase(MTHFR) elevates serum homocysteine level, but it still remains controversial whether the MTHFR gene mutation could be a predictor of ischemic stroke. Therefore, we studied if this genetic defect could cause ischemic stroke independently. Methods : We gathered ischemic stroke subjects and age, sex-matched controls. Age, gender, past medical history, smoking habit, serum homocysteine level, and the MTHFR genotype were recorded. General characteristics of ischemic stroke subjects were compared to the controls. We classified the stroke according to the related vessels(small and large artery infarction) and single lesion and multiple infraction. Relevant risk of the MTHFR genotype was evaluated in each stroke subtype with multiple logistic regression analysis. Results : When the controls were compared to the whole ischemic stroke, there was no specific difference except some medical histories. However, further analysis based on stroke subtypes showed important results. The small artery infarction group, multiple infraction group had significant odds ratio of the MTHFR TT genotype adjusted for age, gender, medical history and smoking habit. Conclusions : The MTHFR TT genotype is an independent risk factor for certain types of ischemic stroke, small artery infarction and multiple infarction.