• Title/Summary/Keyword: 뇌실질내 출혈

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Correlation of Changes of Intracranial Pressure and Clinical Manifestations in Spontaneous Intracerebral Hemorrhage (자발성 뇌실질내혈종 환자에서의 뇌압변화와 임상증상과의 관계)

  • Chung, Eul-Soo;Ko, Sam-Kyu;Kim, Oh-Lyong;Chi, Yung-Chul;Choi, Byung-Yearn;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.35-44
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    • 1991
  • Recently many authors have reported about the relationship of the volumes of hemorrhage in the brain parenchyme, hemorrhagic sites, optimal operation time, and the effects of mannitol and steroid on control of ICP to clinical manifestations. Many attempts to measue ICP in hydrocephalus, brain tumor, and head injury have been reported. But the measurements of intracranial pressure in spontaneous intracerebral hemorrhage are rare. Intracranial pressure was monitored prospectively in 30 patients who had stereotaxic surgery for spontaneous intracerebral hemorrhage. The results are as follows. 1. Intracranial pressure was increased in high $PaCO_2$. 2. There were no correlation in ICP, rebleeding and ADL at discharge(P > 0.05). 3. ICP was the most high level in 72 hours after operation. 4. There was 63.2% decrease in ICP after litigation with 6000 IU urokinase in the site of hemorrhage. 5. There was no correlation between the numbers of natural drainage and ADL at discharge(P > 0.05). 6. The higher the initial GCS, the higher the Postoperative GCS.

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Usefulness of Magnetic Resonance Imaging after Serial Cranial Ultrasound in the Neonates Graduating Neonatal Intensive Care Unit (신생아 중환자실을 퇴원하는 고위험 환아에서 순차적인 뇌초음파 검사 후 시행한 자기 공명 영상의 유용성)

  • Kim, Ji-Hye
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.170-177
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    • 2008
  • Purpose : To evaluate usefulness of MR imaging after serial brain US in the high-risk neonates before discharge of the neonatal intensive care unit. Materials and Methods : Retrospective comparison of 412 US and 121 MR scans in 121 neonates and young infants were performed. Grading of germinal matrix/intraventricular hemorrhage (GMH/IVH) was performed and presence of intracranial hemorrhage other than GMH/IVH and parencyma lesions was also analyzed. Results : Among the 242 lateral ventricles, Seven GMH and 46 IVH were additionally detected by MRI. On the other hand, 30 GMH were only detected by US. US demonstrated Grade 1/2/3/4 GMH/IVH in 24/8/13/0 ventricles each, while each grades were identified in 3, 49, 10, 2 ventricles on MR images. Other intracranial lesions additionally detected on MR images were cerebral hemorrhage (n=4), cerebellar hemorrhage (n=4), extraaxial hemorrhage (n=8), diffuse excessive signal change of the white matter (n=72), non-cavitary lesion (n=4), encephalomalacia (n=2), and ventriculomegaly (n=5). Conclusion : MR imaging could be an excellent complimentary study after serial brain US for additional detection of the intracranial pathology, particularly IVH and white matter lesions, though US would be better in follow-up of GMH in some neonates.

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Organized Expanding Spontaneous Intracerebral Hematoma (조직화한 팽창성 자발성 뇌실질내 혈종)

  • Choi, Byung-Yearn;Moon, Choong-Bae;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.129-134
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    • 1984
  • The authors report a case of massive spontaneous intracerebral hematoma in a infant, caused by bleeding from cryptic vascular malformation associated with vitamin K dependant factor deficiency. The bleeding was initiated by vitamin K dependant factor deficiency, then 3 weeks later hematoma was expanded by rebleeding from malformed vessel after PT and PTT had been returned to normal values. The well circumscribed organized old hematoma with fresh expanded bleeding component within a huge rusty colored cystic fluid cavity was recognized in operative field and pathological ground.

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Clinical Observation for Endotracheal intubation Patients in ICU (중환자실(重患者室)에서 기관내(氣管內) 삽관후(揷管後) 퇴원(退院)한 환자(患者)의 임상통계(臨床統計) 고찰(考察))

  • Nam, Chang-Gyu;Moon, Byung-Soon
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.407-432
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    • 1996
  • Clinical Observation was made on 37 cases of Endotracheal intubation patients in the ICU of Oriental Medical Hosptal of Tae- Jon University from January in 1992 to June in 1995. 1. There were many cases of Endotracheal intubation in ischemic attack hemorragic in order. 2. Cerebral embolism mostly occured in the MCA territory and cerebral thrombosis, ICH, in the pons, generally. 3. On admission the consciousness of the most patients was 3 to 7 point by GCS. 4. The ordinary preceeding disease was hypertension. 5. Most patients were discharged from ICU after 2 days. 5. Most patients were discharged from ICU after 2 days. 6. Endotracheal intubation was done most frequently from 1 p.m. to 3 p.m. and intubated time was less than 2 hours. 7. Endotracheal intubation was done in case of heart arrest than dyspnea cases. 8. The main complication of patients of C.V.A. in ICU were urinary tract infection, pneumonia in order. 9. There were no side effects after and by Endotracheal intubation.

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Diffusion-weighted MR imaging findings of intracerebral hematoma (뇌실질내의 확산강조영상 소견)

  • 박창숙;최순섭;오종영;박병호;김기욱;남경진;이영일
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.1
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    • pp.21-27
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    • 2002
  • Purpose : To evaluate diffusion-weighted imaging findings of intracerebral hematoma according to the time sequence. Materials and methods : Seventeen patients with intracerebral hematoma were studied. Diffusion weighted images using 1.5 tesla MRI machine were obtained with b-value of $1000{\;}sec/\textrm{mm}^2$. The patients were grouped as hyperacute stage(within 12 hours, 5 patients), acute stage(within 3 days, 4 patients), subacute stage(within 3 weeks, 4 patients), and chronic stage(after 3 weeks,4 patients). The signal intensities were analysed as bright, high, iso, low and dark at the central and peripheral portions of the hematoma in each stage, and compared with those of T2 and T1 weighted images. Results : The signal intensities of the central and peripheral portion of the intracerebral hematoma on diffusion-weighted images were high and dark in hyperacute stage, dark and high-bright in acute stage, and high-bright and dark in subacute and chronic stages. The patterns of signal change of hematoma on diffusion-weighted image according to the time sequence were similar to those on T2-weighted image, but changed early and prominently. Conclusion : The intracerebral hematoma on diffusion-weighted image showed unique central and peripheral signal intensity according to the time sequence. Central portions show high to bright signals in hyperacute, subacute and chronic stage, and dark signal in acute stage, and peripheral portions show dark signals in hyperacute, subacute and chronic stage, and high to bright signal in acute stage.

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Rhinocerebral Mucormycosis with Intracerebral Hemorrhage (뇌실질내 출혈을 동반한 비뇌 모균증)

  • Shin, Pill Jae;Lee, Ho Kook;Kim, Chang Hyun;Yang, Kyung Hun;Hwang, Do Yun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.136-142
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    • 2000
  • Rhinocerebral mucormycosis is a rare but acutely fatal disease caused by fungi belonging to the order Mucorales, and characterized by an aggressive necrotizing infection spreading from the nose to the paranasal sinuses, orbit, and then to the central nervous system. It most frequently develops in individuals with poorly controlled diabetes mellitus. The authors report a 65-year-old woman who developed intracerebral hemorrhage during treatment for rhinocerebral mucormycosis associated with diabetes mellitus. Despite the treatment, she became worse. The pertinent literatures were reviewed.

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Glioblastoma Misdiagnosed as Brain Abscess after Surgical Evacuation of Spontaneous Basal Ganglia Hemorrhage (기저핵부 뇌실질내 출혈에 대한 수술후 뇌농양으로 오인한 다형성 교아세포종)

  • Cheong, Jin Hwan;Kim, Jae Min;Bak, Koang Hum;Park, Yong Wook;Kim, Choong Hyun;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.384-388
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    • 2001
  • A 51-year-old woman presented with sudden severe headache, vomiting, and right hemiparesis at first admission. Computed tomography(CT) scans revealed an hemorrhagic density at left basal ganglia. Preoperative cerebral angiography showed no vascular lesion. Under the diagnosis of hypertensive intracerebral hemorrhage(ICH), total extirpation of hematoma was done. The postoperative neurological condition improved gradually and discharged without any neurological sequelae. Two months later, she revisited with headache, vomiting and progressive right hemiparesis. CT scans at second admission showed an irregular rim enhanced mass with central low density with surrounding edema at the initial bleeding area. Repeated craniotomy was performed and the mass was partially removed. The histopathological diagnosis of the specimen was confirmed as glioblastoma. The authors report a glioblastoma, which occurred at initial ICH site and regarded as a brain abscess with literature review.

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Analysis of the Risk Factors of Hematoma Enlargement in Patients with Spontaneous Intracerebral Hemorrhage (자발성 뇌실질내 출혈 환자에서 혈종 증가의 위험 인자에 대한 분석)

  • Lee, Yong-Mook;Koh, Hyeon-Song;Youm, Jin-Young;Kim, Seong-Ho;Song, Shi-Hun;Kim, Youn
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.437-442
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    • 2001
  • Objective : The purpose of this study was to evaluate the risk factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). Methods : A series of 214 ICH patients diagnosed by brain CT scan in our neurosurgery department from June 1995 to July 1998 were reviewed with clinical status, past medical histories, laboratory findings, CT findings and prognosis. Results : In 27 patients(12.6%), the second CT scan showed an enlarged hematoma. Age, sex, and site of hematoma were not related to hematoma enlargement. A long interval(>6 hours) between the onset and the 1st CT scan strongly reduced the incidence of hematoma enlargement. The incidence of hematoma enlargement significantly increased in patients with previous history of hypertension, cerebral infarction and ICH. This analysis also demonstrated the following independent factors predisposed to hematoma enlargement : initial high systolic blood pressure, high serum total protein, low serum albumin, low serum sodium, prolonged prothrombin time(>14 sec) and activated partial thromboplastin time(>29.5 sec), irregular hematoma shape, and combined intraventricular hemorrhage. Prognosis in the group of hematoma enlargement showed high mortality(48.1%) and poor outcome. Conclusion : Patients with previous history of hypertension, cerebral infarction and ICH, and with high systolic blood pressure, prolonged coagulation time, irregular hematoma shape and intraventricular hemorrhage in CT scan should be observed carefully. And, early surgical therapy of large hematoma and meticulous control of blood pressure may decrease the mortality and morbidity in patients with spontaneous ICH.

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