• Title/Summary/Keyword: 지주막하출혈

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A Case Report of Quadriparesis due to Subarachnoid Hemorrhage with Intraventricular Hemorrhage due to Cerebral Aneurysm Rupture Improved after Treated with Korean Medicine Treatment Including Tonggyuhwalhyeol-tang-gagambang (통규활혈탕가감방을 포함한 한의복합치료로 뇌동맥류 파열에 의한 뇌실내출혈을 동반한 지주막하출혈 환자의 사지마비에 개선을 보인 증례보고 1례)

  • Seong-hyeon Jeon;Eun-soo Park;Yu-bin Kim;Ji-su Lee;Eun-yeong Park
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.1050-1061
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    • 2023
  • This study reported the case of a patient with quadriparesis due to cerebral aneurysm rupture, subarachnoid hemorrhage, and intraventricular hemorrhage (IVH) treated with Korean medicine. The patient was treated with acupuncture, herbal medicine (mainly Tonggyuhwalhyeol-tang-gagam), Western medicine, moxibustion, cupping, and rehabilitative therapy for 75 days, and improved after administration. After treatment, the Manual Muscle Test grade improved from 4/4-/3+/3 to 4+/4+/4+/4+, the Korean version of the modified Barthel Index score improved from 9 to 100, the National Institute of Health's Stroke Scale score improved from 2 to 0, the Global Deterioration Scale score improved from 3 to 2, and the Korean version of the Mini-Mental State Examination score improved from 22 to 30. During administration, the patient did not show seizures, shock, or loss of consciousness, and the vital signs were stable in the normal range. We followed up the brain computed tomography findings for 2 times and found that there was no definite evidence of intracranial hemorrhage or IVH or re-rupture or rebleeding after Korean medicine treatment. This study suggests that Korean medicine treatment with blood-invigorating and stasis-removing herbs could be a safe and effective intervention option for improving quadriparesis due to cerebral aneurysm rupture and subarachnoid hemorrhage.

Risk of Seizures after Operative Treatment of Ruptured Cerebral Aneurysms (뇌동맥류 파열 환자의 수술 후 경련발작의 위험인자)

  • Chang, In-Bok;Cho, Byung-Moon;Shin, Dong-Ik;Shim, Young-Bo;Park, Se-Hyuck;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.705-710
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    • 2001
  • Objective : Postoperative seizure is a well documented complication of aneurysm surgery. The purpose of the present study was to analyze risk factors for postoperative seizure. Methods : Between January 1990 and December 1996, we performed craniotomy for ruptured cerebral aneurysms in 321 patients. Among them 206 patients who could be followed up for more than 1 year(range, 1 to 4.6 years) were enrolled to present study. All patients were treated with anticonvulsants for 3 to 18 months postoperatively. We analyze the incidence of postoperative seizure in different sex and age groups, and risk factors associated with postoperative seizures following aneurysm rupture. For statistical processing chi-square test and Fisher's exact test were used. Results : In the follow-up period of 1 to 4.6 years(mean, 1.8 years) postoperative seizure appeared in 18 out of 206 patients(8.7%). Mean latency between the operation and the first seizure was 6 months(range, 3 weeks to 18 months). The age of the patients has significant influence on the risk of seizure, it occurred more often in younger patients(p =0.0014). Aneurysm location in the MCA was associated with a significantly a higher risk of seizure(p = 0.042). Eight patients(19%) out of 42 patients who suffered delayed ischemic neurologic deficit(DID) developed seizure. Delayed ischemic neurologic deficit was associated with significantly a higher risk of seizure(p =0.019). Infarct and hypertension were associated with significantly a higher risk of seizure(p <0.05). pre- or postoperative intracranial hematoma(intracerebral or epidural hematoma) was associated with significantly a higher risk of seizure(p <0.0001). H-H grade, Fisher grade, Glasgow Outcome Scale of patients and timing of operation after subarachnoid hemorrhage had no significant relation with the risk of seizure. Conclusion : Factors associated with the development of postoperative seizure were middle cerebral artery aneurysm, delayed ischemic neurologic deficit, infarct on late postoperative CT scan, hypertension, pre or postoperative intracranial hematoma(intracerebral or epidural hematoma). Identification of the risk factors may be help to focus the antiepileptic drug threapy in cases prone to develop seizures. Prospective evaluation is indicated.

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Case Reports of Korean Medicine Treatment of Two Patients with Oculomotor Nerve Palsy Complaining of Ptosis and Limitation of Eye Movement After Subarachnoid Hemorrhage (지주막하출혈 후 안검하수와 안구운동장애를 호소하는 동안신경마비 환자의 한방치료 증례보고 2례)

  • Lee, Hyun-seung;Shim, Sang-song;Jeong, Sol;Shin, Yong-jeen;Yun, Jong-min;Moon, Byung-soon
    • The Journal of Internal Korean Medicine
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    • v.41 no.5
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    • pp.745-753
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    • 2020
  • Background: A number of studies have identified the effect of Korean medicine treatment for oculomotor nerve palsy, but few have reported treatment of subarachnoid hemorrhage. This paper reports two cases of oculomotor nerve palsy with ptosis and limitation of eye movement after subarachnoid hemorrhage whose conditions were improved by Korean medicine treatment. Methods: Two patients with ptosis and limitation of eye movement after subarachnoid hemorrhage were treated with Korean medicine, including acupuncture, electroacupuncture, herbal medicine, cupping, moxibustion, and pharmacoacupuncture. Clinical symptoms were measured as the distance of the interpalpebral fissure and eyeball movement (adduction, abduction). Results: After treatment, their clinical symptoms showed improvement. Conclusion: Korean medicine treatment, including pharmacoacupuncture and electroacupuncture, could be adopted as a treatment method for oculomotor nerve palsy after subarachnoid hemorrhage.

A Case Report of a Subarachnoid Hemorrhage Patient whose Paresthesia Improved by Ssanghap-tang (쌍합탕 투약 후 수족부 저림증이 호전된 지주막하출혈 환자 증례보고)

  • Hong, Seungcheol;Min, Seonwoo;Moon, Jiseong;Kim, Hakkyeom;Kim, Youngji;Song, Juyeon;Ahn, Lib;Shin, Gil-cho;Choi, Dong-jun
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.21 no.1
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    • pp.77-84
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    • 2020
  • ■ Objectives This case is to report the effect of Ssanghap-tang on paresthesia of a subarachnoid hemorrhage patient. ■ Methods A male Korean patient was treated with Ssanghap-tang and acupuncture, moxibustion for total 30 days. We observed limbs numbness, circumferences, other symptoms such as weakness and any adverse event. ■ Results After treatment, numeric rating scale of limb numbness was improved to 5 from 8 at admission without any adverse event. However, we could not find any significant differences on hand circumference and limb weakness. ■ Conclusion This case suggests that Ssanghap-tang and acupuncture, moxibustion therapy could be effective in improving paresthesia of subarachnoid hemorrhage patient.

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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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Comparison of Stent-Assisted Coil Embolization Versus Coil Embolization Alone for Ruptured Cerebral Aneurysms with Mild Symptoms: A Single-Clinic Experience (경미한 증상을 가지는 파열 뇌동맥류의 치료에 있어서 스텐트를 이용한 코일 색전술과 단순 코일 색전술의 비교: 단일 병원 경험)

  • Gayeong Lim;Shang Hun Shin;Tae Young Lee;Woon-Jung Kwon;Byeong-Su Park;Soon Chan Kwon
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.887-897
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    • 2022
  • Purpose To evaluate the safety and efficacy of stent-assisted coil embolization (SAC) in acutely ruptured cerebral aneurysms without severe symptoms, and thus, the usefulness of the stent itself in patients with subarachnoid hemorrhages. Materials and Methods From January 2017 to June 2019, 118 patients were treated with coil embolization for acutely ruptured cerebral aneurysms without severe symptoms (Hunt & Hess grade ≤ 3). The periprocedural complications, six-month modified Rankin scores (mRS), and six-month radiologic outcomes were compared between 56 patients with SAC and 62 patients without SAC (non-SAC). Results The rate of good clinical outcomes (mRS ≤ 2), as well as the rate of hemorrhagic and ischemic complications, showed no significant difference between the SAC and non-SAC groups. Moreover, compared to the non-SAC group, the SAC group showed a lower recanalization rate on the six-month follow-up angiogram (20% vs. 39.3%, p = 0.001). Conclusion Although stent use was not significantly associated with clinical outcomes in coil embolization of ruptured cerebral aneurysms with non-severe symptoms (Hunt & Hess grade ≤ 3), it significantly decreased the rate of recanalization on follow-up cerebral angiograms.

The Effect of Yangkyuksanhoa-tang Extracts on the Morphological Changes of the Basilar Artery after Cerebral Subarachnoid Hemorrhage (지주막하출혈에 의한 뇌기저동맥의 형태학적 변화에 미치는 양격산화탕(凉膈散火湯)의 효과)

  • Lee, Dong-Won;Lee, Won-Chul
    • The Journal of Korean Medicine
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    • v.20 no.2
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    • pp.146-156
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    • 1999
  • The present study was performed to investigate the effect of Yangkyuksanhoa-tang on the morphological changes of the basilar artery after experimentally induced subarachnoid hemonrrhages(SAH). Yangkyuksanhoa-tang has been used freguently for cerebrovascular accident Sprague Dawley rats weighing between 350-400 g were used. The 6 normal rats and 24 SAH elicited rats were used, The SAH induced by injection of the fresh autologus heart blood (0.3-0.4 ml) into the cisterna magna through the posterior atlanta-occipital membrane, Sample group was given 3.3 ml/kg/day of Yangkyuksanhoa-tang extracts for 2 days after SAH. The experimental animals were killed at 48hrs after SAH. The morphological changes of the arterial walls were examined by light and electron microscopy. Following are the obtained results: 1. In SAH elicited rats, the size of the lumen in basilar artery was diminished by about 45% and the thickness of arterial wall was increased by about 82%. In SAH elicited rats with Yangkyuksanhoa-tang treatment, the size of the lumen in basilar artery was merely diminished by about 18% and the thickness of arterial wall was merely increased by about 19%. 2. In light microscopic examination, the endothelium was swollen into a cuboid shape and the layer of smooth muscle was increased in the basilar artery of SAH elicited rats. In SAH elicited rats with Yangkyuksanhoa-tang treatment, the size of the lumen in basilar artery was enlarged and the thickness was decreased than in SAH elicited rats. The endothelium was flattened into a squamous shape and the layer of smooth muscle was decreased more than in SAH elicited rats. 3. In electron microscopic examination, the endothelial cells with fragmentation nuclei were changed into a cuboid shape and the internal elastic lamina were folded at the basilar artery of SAH elicited rat. The nuclei of smooth muscle cells were changed into a round or crumpled shape. The length of smooth muscle was shorten and thickness was increased. But all kinds of morphologic changes were diminished in SAH elicited rats with Yangkyuksanhoa-tang treatment. Conclusion : Yangkyuksanhoa-tang extracts were effective to treat cerebral vasospasm after experimentally induced subarachnoid hemorrhage in rats.

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A Study on Factors Related to Stroke Patients in Taegu Area (한방병원 내원 뇌졸중 환자에 대한 역학적 조사)

  • 김웅각
    • Biomedical Science Letters
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    • v.4 no.2
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    • pp.153-164
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    • 1998
  • A study on factors related to stroke patients in three oriental medical hospitals in Taegu area was conducted from October 1997 through December 31, 1997. One hundred and sixty three hospitalized and ambulatory patients were interviewed by traind interviewers according to the questionnaires prepared in advance. The results are summarized as follows; male and female ratio of the subjects was 1 to 1.36, and of the subjects 36.8% were 60's of the age and 25.2% were 50's and 19.6% were 70's. 74.7% of the patients were married and 41.5% of them had only six year education. 20% of the subjects became stroke victims while they were engaged in physical activities, 16.2% while in sleep, 15.5% because of psycological shock, and 7.2% while drinking. Of 157 precisely diagnosed cases, cerebral infarction was the most frequent cause (47.7%), cerebral hemorrhage was the second (38.2%), and subarachnoid hemorrhage (5.1%) respectly, Of 161 cases, 64% were normal in body weight, 26.7% were obese and 9.3% were light. Of 163 cases, 65.6% of them did not drink alcohol. Of 162 cases, 63% did not smoke cigarettes.

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A Clinical Study for 157 Cases of CVA by Sasang Constitutional Medicine (사상의학적(四象醫學的) 중풍치험(中風治驗) 157례(例)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Choi, Jae-young;Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.2
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    • pp.431-453
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    • 1998
  • 1. Background and Purpose: We intended to make the standards of CVA management of Sasang Constitutional Medicine and be helpful to understand the constitutional symptoms through a clinical study of CVA. 2. Methods: We studied 157 CVA inpatients(79 men and 78 women) who were in constitutional clinic of Dongguk Pundang Oriental Hospital during 1 year from March 1997 to February 1998. We investigated and analysed the characteristics, past histories, symptoms and progresses of patients. 3. Results: The results of constitutional analysis showed 88 Taeumin(56.1%), 48 Soyangin(30.6%) and 21 Soeumin(13.4%). The frequency of strokes was much the same between male and female and the greater part of cases were 50-70 of age. The CVA cases were classified into 119 cerebral infarction(75.8%), 11 cerebral hemorrhage(7.0%), 1 subarachnoid hemorrhage(0.6%) and 26 trasient ischemic attack. From the standards of symptom management, there were abnormality of a coated tongue(63.1%) in most cases, sleeping disorders(48.4%), excremental disorders(44.7%) and urinary disorders(36.9%) on admission. With regard to the rate of improvement in the standards of CVA management, excremental disorders improved 87.1% and emotional disorder 81.0%, swallowing disorder 78.7% and so on.

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A Clinical Study of Two Patients Suffering from Normal Pressure Hydrocephalus (정상뇌압수두증(正常腦壓水頭症) 환자(患者) 치험(治驗) 2례(例)에 대(對)한 임상보고(臨床報告))

  • Cho, Bong-Hyun;Yu, Byeong-Chan;Kim, Yoon-Sik;Seol, In-Chan
    • Korean Journal of Acupuncture
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    • v.22 no.1
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    • pp.43-53
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    • 2005
  • Objective : This study was designed to investigate the effect of the Sa-Am Acupuncture treatment on two patients suffering from Normal Pressure Hydrocephalus(NPH). Methods : We selected the two patients who were admitted with NPH. The patients were women with complaints of gait disturbance, dementia, incontinence, hemiparesis and dysarthria, after occurring of cerebral infarction or SAH. We treated the two patients by Sa-Am Acupuncture treatment method and herbal medication. One patient was treated during 64 days, the other was treated during 14 days. Results & conclusions : The Sa-Am Acupuncture treatment was effective on one pateint, not the other. After treatment through oriental medicine, including Sa-Am Acupuncture treatment method, one patient was improved but the other was not changed. Therefore, this application of oriental medicine and Sa-Am Acupuncture treatment are reported with a plea for further investigation.

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