• Title/Summary/Keyword: 경막하

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A Review of Recent Korean Medicine Treatment for Chronic Subdural Hematoma Using the CNKI Database (만성 경막하 혈종(Chronic Subdural Hematoma)의 한의 치료에 대한 최신 임상연구 동향 - CNKI 검색을 중심으로 -)

  • Je, Yu-ran;Kim, Kyong-lim;Hwang, Won-deok
    • The Journal of Internal Korean Medicine
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    • v.42 no.3
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    • pp.308-322
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    • 2021
  • Objectives: This study investigates the latest clinical studies on Korean medicine treatment of chronic subdural hematoma (CSDH) in China. Methods: A CNKI search investigated the last 10 years of clinical studies of Korean medicine treatments in Chinese medical journals for CSDH. The search focused on authors, publication years, types of studies, purposes of studies, methods and duration of treatment, evaluation criteria, and results of treatment. Results: In 19 studies, there were 14 randomized controlled trials (RCTs), 4 case series, and 1 case-control study. In all 19 studies, Korean medical treatment and Western treatment were combined. Herbal medicine was used in 19 studies and acupuncture treatment in 2 studies. The most frequently used prescription was Hyeolbuchukeo-tang-gagambang, and the most frequently used acupoint was PC6. In all 19 studies, the effectiveness of Korean medicine treatment performed in parallel with Western treatment was confirmed. Conclusions: In this study, Korean medicine combined with Western treatment for CSDH was effective. More clinical studies and case reports are required to develop a guided treatment for CSDH.

Late-Onset Spinal Subdural Hematoma after Acupuncture (침술치료 후 발생한 지연성 척추 경막하 혈종)

  • Park, Hyo Sik;Kim, Jong Keun;Bae, Jin Seok;Jeong, Yong Sung;Lim, Jong Youb
    • Clinical Pain
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    • v.18 no.2
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    • pp.130-132
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    • 2019
  • Acupuncture is generally regarded as a safe procedure and as a popular treatment for patients with musculoskeletal disorders. We report a case of a 47-year-old male patient with late-onset tetraplegia, developed after acupuncture. He had no trauma, medical, and social history relevant to tetraplegia. Right after the acupuncture, he felt discomfort in his right arm. After 6 days, all 4 extremity weakness developed. Whole-spine magnetic resonance imaging revealed the presence of spinal subdural hematoma extending from the C5 vertebra to the coccyx level. Hand coordination dysfunction, neurogenic bladder, and neuropathic pain were other symptoms. After the management, he recovered muscle strength, but incomplete bladder control and neuralgia were sustained. It is important to be aware of the possibilities of severe complications after acupuncture.

Borden Type I Sigmoid Sinus Dural Arteriovenous Fistula Presenting as Subarachnoid Hemorrhage from a Feeding Artery Aneurysm of the Anterior Inferior Cerebellar Artery: A Case Report (Borden I 유형의 S상 정맥동 경막 동정맥루의 공급 동맥인 전방 하뇌 소뇌 동맥의 동맥류 파열로 인한 지주막하 출혈: 증례 보고)

  • Myojeong Kim;Sung-Tae Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1472-1477
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    • 2020
  • Dural arteriovenous fistula is an acquired vascular anomaly that can cause various symptoms. Here, we report a rare case of Borden type I sigmoid sinus dural arteriovenous fistula presenting as subarachnoid hemorrhage. Bleeding occurred from a side-wall aneurysm in the lateral pontomedullary segment of the anterior inferior cerebellar artery, which was a minor pial feeder. Features on imaging modalities, including brain CT, CT angiography, MR imaging/angiography and digital subtraction angiography, are described with a literature review.

Dilatation of Superior Ophthalmic Vein and Visual Disturbance by Central Venous Stenosis: A Case Mimicking Cavernous Sinus Dural Arteriovenous Fistula (상안정맥 확장 및 시력 저하를 보인 중심정맥협착: 해면경막 동정맥루로 오인된 증례 보고)

  • Young Hun Jeon;Kyung Sik Yi;Chi Hoon Choi;Yook Kim;Yeong Tae Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1619-1627
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    • 2021
  • Central venous stenosis is a relatively common complication in hemodialysis patients; however, jugular venous reflux (JVR) and increased intracranial pressure are rare, and associated progressive visual disturbance was reported in only a few cases. Here, we report a case of JVR with visual disturbance and increased intracranial pressure. Notably, the MRI was accompanied by a dilatation of the superior ophthalmic vein, which was mistaken for a cavernous sinus dural arteriovenous fistula (CSdAVF). The patient had JVR on time-of-flight MR angiography (TOF-MRA) and severe stenosis of the left brachiocephalic vein on conventional angiography. After balloon angioplasty for central venous stenosis, he was discharged after improvement of his visual disturbance. Although JVR due to central venous stenosis and CSdAVF might show similar symptoms, treatment plans are different. Therefore, it is important to distinguish radiologically based on a thorough review of MRI and TOF-MRA and confirm the central venous stenosis on cerebral angiography for the accurate diagnosis.

Heart-Lung Transplantation in a Patient with VSD, PDA and Eisenmenger′s Syndrome (심실 중격 결손과 동맥관 개존증을 동반한 아이젠멩거 증후군 환자에서의 심장-폐이식 수술 -1예 보고-)

  • 홍유선;김도형;함석진;이교준;이두연;권혁문;김형중;조상호;백효채
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.418-421
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    • 2003
  • Heart-lung transplantation is a widely accepted treatment for Eisenmenger'syndrome. The patient is a 41-years-old male diagnosed with Eisenmenger'syndrome due to patent ductus arteriosus. The pressures were checked as follows: aorta 130/80 mean 100 mmHg, pulmonary artery 130/80 mean 109 mmHg, and right ventricle 130/20 mmHg, right atrium mean 20 mmHg. The patient needed heart-lung transplantation due to enlarged right pulmonary artery (diameter 7.5 cm). The donor was a 24 years-old male diagnosed as brain death due to subdural hematoma. Ligation of patent ductus arteriosus was performed under the cardiopulmonary bypass followed by heart-lung transplantation. Patient was extubated on postoperative day one, transferred to the general ward on day 3, and was discharged on postoperative day 33. Cardiac and lung biopsy was performed on postoperative day 41 with no signs of rejection.

A Case of Subdural Empyema Caused by Sinusitis in a Child (부비동염이후 발생한 경막하 농양 1례)

  • Byun, Jung Hee;Hwang, In Kyung;Park, Eun Kyung;Kang, Ju Wan;Kim, Dong Soo;Jang, Gwang Cheon
    • Pediatric Infection and Vaccine
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    • v.21 no.1
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    • pp.59-64
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    • 2014
  • The current paper reports on a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy child. Sinusitis is a common and benign condition in most pediatric cases. Because of the widespread use of antibiotics, intracranial extension of pediatric sinusitis is rarely seen today; however, complications (e.g., cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema) are potentially life threatening. A 15-year-old right-handed male presented with a 3-day history of fever, headache, and left-sided palsy. Computed tomography revealed right-sided subdural empyema with right frontal sinusitis and maxillary sinusitis. A postoperative inpatient neurological consultation was requested 2 months post-surgery due to motor function deficits. The results suggested that early and accurate diagnosis of subdural empyema leads to prompt treatment and a favorable outcome for the patient.

Accidental Subdural Steroid Injection during Intended Epidural Block Relieves Intractable Radiculopathy in Failed Back Surgery Syndrome -A case report- (경막외차단 중 발생된 우발적 경막하 스테로이드 주입에 의한 난치성 요추수술 후 실패증후군의 치료 경험 -증례 보고-)

  • Jung, Gi-Seung;Song, Sun-Ok;Cho, Young-Woo
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.104-109
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    • 2001
  • We describe the accidental injection of local anesthetics containing steroid into the subdural space during an attempted lumbar epidural injection for intractable radiculopathy in a patient with failed back surgery syndrome. A 24-year-old man complained of severe radiating pain to left lower extremity and showed a walking disturbance and severe lumbar scoliosis. The MRI finding was a left paramedian recurred disc herniation on L4-5 in a laminectomy state. Several therapeutic modalities such as epidural steroid injection, transforaminal injection, L2 root block, medication, and exercise therapy, etc failed. Initially, during epidural block at L4-5 under fluoroscopic guidance, a railroad track appearance appeared on epidurogram suggesting the presence of a subdural space. A second epidural block was tried at L5-S1. Following confirmation of epidural space upon epidurogram, 6 ml of 0.5% lidocaine including triamcinolone 40 mg was injected. The patient showed signs of the subdural injection including an unexpectedly high sensory block (T2) and a motor weakness of both lower extremities. Following this event, the severe radiculopathy and lumbar scoliosis were improved. Therefore, we conclude that subdural injection of steroid could be helpful in intractable radiculopathy, especially in the failed back surgery syndrome. However, it must be used cautiously with careful patient selection.

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Emergency Trephination Site of Acute Subdural Hematoma (급성 경막하 혈종에서 응급 두개골 천공의 위치)

  • Moon, Soo-Hyeon;Kim, Geun-Hoe;Kwon, Taek-Hyun;Park, Youn-Kwan;Chung, Hung-Seob;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.659-663
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    • 2000
  • The motality rate of acute subdural hematoma(ASDH) associated with closed head injury is high in spite of recent advances in neurosurgery. Many variables in regard to outcome of ASDH have been assessed. But among them, intracranial pressure(ICP) control and the time interval between injury and operative evacuation are the only things that can be affected by doctor. We introduced a simple method to the management of ASDH for reducing the time interval between injury and operation. When the immediate decompressive operation of ASDH was impossible by any causes, we made a burr hole at the center of hematoma, usually on 2-3cm above temporal squama and 1-2cm behind coronal suture under local anesthesia before main operation. Partial hematoma evacuation was achieved through the burr hole and it was effective in preventing further worsening of patients neurological status before main operation. Prompt hematoma evacuation through the burr hole seemed to be effective in delaying secondary ischemic brain damage and made easy to closing the dura opening and replacement of the bone flap at the end of main decompressive operation. This easy method may reduce the time interval between injury and operation. We represent surgical technique with two cases of ASDH managed with this simple method.

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Late Detection of Chronic Subdural Hematoma in Traffic Accident Patients Who Treated Tibial Fractures; Report of 2 Cases (경골골절 치료 중 만성 경막하 혈종이 발견된 교통사고 환자 2례 고찰)

  • Kim, Byung-Jun;Shin, Byung-Cheul;Hwang, Eui-Hyoung;Hwang, Man-Suk;Heo, In;Heo, Kwang-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.3
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    • pp.119-125
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    • 2015
  • A chronic subdural hematoma (CSDH) is an old collection of blood and blood breakdown products between the surface of the brain and its outermost covering. We present two cases with tibia fracture caused by traffic accident progressed to chronic subdural hematoma. A 72-year-old male patient had shown signs of headache, urinary incontinence and mental storm when he has been in the hospital after 3weeks without CSDH diagnosis. And a 78-year-old male patient with mild head injury suffered from right side headache after traffic accident. We took korean medical treatments associate with tibial fracture. And we knew subdural hematoma through Brain CT. It is good report which shows CSDH can can occur from traffic accident. It requires correct diagnosis and closed observation for traffic accident patients.