• Title/Summary/Keyword: 지주막하 출혈

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업무상 재해의 판례 - 과로와 스트레스로 인한 혈압 상승이 뇌동맥류 파열의 원인이고, 휴무 중 과로 행위를 입증할 객관적 자료가 없다면 업무상 재해가 인정된다

  • 대한산업보건협회
    • 월간산업보건
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    • s.257
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    • pp.52-58
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    • 2009
  • 원고가 피동맥류 파열로 인한 지주막하 출혈 발병 무렵 연장 근무와 과중한 업무로 피로가 누적됐음을 알 수 있고, 달리 원고가 휴무 중에 과로의 원인이 될 만한 행위를 하였다고 인정할 객관적 자료가 없다면, 원고의 과중한 업무와 지주막하 출혈의 원인이 되는 혈압 상승 사이에 상당 인과 관계가 있다고 할 것이다.

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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.

Recovery State of Hemorrhagic Stroke Patients: Exploratory Comparison of Recovery State between Spontaneous Intracerebral Hemorrhage(s-ICH) and Spontaneous Subarachnoid Hemorrhage(s-SAH) (출혈성 뇌졸중 환자의 회복: 자발성 뇌출혈(s-ICH) 환자와 자발성 지주막하 출혈(s-SAH) 환자의 회복 정도에 대한 탐색적 차원의 비교 연구)

  • Oh, Hyun-Soo;Seo, Wha-Sook;Cho, Hwa-Yeon;Kim, Mi-Og;Kim, Mi-Ran;Mo, Jin-A
    • Korean Journal of Adult Nursing
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    • v.20 no.4
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    • pp.600-612
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    • 2008
  • Purpose: This study was conducted to compare the recovery state of 6 month between s-ICH and s-SAH patients. The patients' recovery state was measured with 2 dimensions: functional and cognitive. Methods: Non-experimental prospective design was adopted by including 108 hemorrhagic stroke patients(s-ICH: 52 vs s-SAH: 56) admitted to Intensive Care Unit of one university hospital. Results: The study results showed that overall functional recovery state of s-SAH patients was better than that of s-ICH patients, and s-SAH patients also showed better recovery states in all of the sub-dimensions of functional recovery, such as feeding, grooming, and toileting, than those of s-ICH in 6 month. On the contrary, the study results showed that overall cognitive recovery states of 6 month between two groups were not significantly different. However, according to the results comparing the sub-dimensions of cognitive recovery, s-SAH patients' recovery states on attention, communication and memory were significantly better than those of s-ICH patients, while recovery states on problem solving, safety behavior, and social behavior between 2 groups were not significantly different. Conclusion: From the study results, it was noted that s-SAH patients showed better recovery states in cognitive dimension as well as in functional dimension compared with s-ICH patients.

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Detection of Acute Subarachnoid Hemorrhage: Comparison of FLAIR MR Imaging with Unenhanced CT (급성 거미막하 출혈의 진단: FLAIR MR영상과 조영전 CT와의 비교)

  • Choi, Won-Jin;Choi, Dae-Seob;Kim, Joung-Hae;Kim, Soon;Lee, Hyeon-Kyeong;Oh, Yoen-Hee;Kim, Seung-Hyeon;Lee, Sung-Woo;Kim, Wook-Nyeon;Lee, Kyu-Chun
    • Investigative Magnetic Resonance Imaging
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    • v.5 no.2
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    • pp.149-154
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    • 2001
  • Purpose : Our aim was to evaluate the usefulness of fluid-attenuated inversion recovery (FLAIR) MR imaging for detection of acute subarachnoid hemorrhage (SAH) compared with unenhanced CT. Materials and methods ; We compared FLAIR MR images with unenhanced CT scans in 28 patients with acute SAH. Findings of SAH on CT and MR images were graded as 0 (absence), 1 (suspicious), 2 (definite) in the cerebral sulci, sylvian fissure, basal cistern, and cisterns of the posterior fossa. We also compared FLAIR MR images of 28 patients with those of 35 normal subjects, and then the sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of acute SAH were calculated. Results : FLAIR MR image was superior to CT in detecting SAH in the posterior fossa ($1.41{\pm}0.74{\;}vs{\;}0.78{\pm}0.80$; p<0.05) and cortical sulci ($1.11{\pm}0.80{\;}vs{\;}0.70{\pm}0.83$; p<0.05). There was no significant difference between FLAIR MR image and CT in detecting SAH in the basal cistern and sylvian fissure. The sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of SAH were 100% in all. Conclusion : FLAIR MR image is useful in detecting acute SAH, especially in patients with small amount of SAH or SAH in the posterior fossa.

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Characteristics and Interventions for Headaches among Inpatients with Subarachnoid Hemorrhage (지주막하 출혈로 입원한 환자가 경험하는 두통의 특성과 중재)

  • Yun, Sun-Hee;Cho, Ok-Hee;Yoo, Yang-Sook
    • Journal of Home Health Care Nursing
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    • v.21 no.2
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    • pp.110-119
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    • 2014
  • Purpose: The objectives of this study were to identify interventions and to analyze the characteristics of headaches among hospitalized patients with subarachnoid hemorrhage with moderate or severe headaches. Methods: A retrospective review of the electronic medical records of 210 patients who received treatment for subarachnoid hemorrhage was conducted. Data collection was done using a structured headache record sheet. Data analysis was carried out using the PASW 18.0 version program. Results: There were significant differences in number and duration of headaches of headaches according to the presence of vasospasm, increased intracranial pressure, extraventricular drainage, use of hypertonic solution, and hospitalization period (p<0.05). Patients with vasospasm and extraventricular drainage experienced the most severe headache for a duration of 3 to 7 days. Other patients experienced the most severe headache for around 1-2 days. Conclusion: Hospitalized patients with subarachnoid hemorrhage who had vasospasms experienced more headaches and the duration of these headaches were longer. In particular, the assessment and interventions for headaches should increase and be carried out actively during this time because the intensity of these headaches is severe and lasts for 3-7 days. Additionally, we emphasize the need for regular administration of analgesics in order to promote patients' well-being. On the basis of the results of this study,we suggest that evidence-based interventions for the care of headaches among hospitalized patients with subarachnoid hemorrhage should be developed.

Utility of Acetazolamide-Enhanced Brain Perfusion SPECT in Predicting Outcome of the Patients with Aneurysmal Subarachnoid Hemorrhage (뇌동맥류파열에 의한 지주막하 출혈환자의 예후평가에 있어서 아세타졸아미드 부하 뇌혈류 SPECT의 유용성)

  • Choi, Yun-Young;Kim, Jae-Min;Kim, Kwang-Myung;Choe, Il-Seung;Cho, Suk-Shin
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.241-250
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    • 2001
  • Purpose: Vasospasm is a complication of aneurysmal subarachnoid hemorrhage (aSAH). We assessed the role of acetazolamide-enhanced brain perfusion SPECT (ACZ-SPECT) with Tc-99m ECD for predicting the prognosis of patients with aSAH. Materials and methods: Two SPECT studios (baseline with 740 MBq and ACZ-SPECT with 1480 MBq) with image subtraction were performed in 21 patients with aSAH. All patients had brain CT and angiogram. Vasoreactivity on ACZ-SPECT, perfusion defect on baseline SPECT, and vasospasm on angiogram were correlated with Hunt-Hess grading, extent of SAH (unilateral or bilateral) on CT, and clinical outcome. Vasoreactivity was considered decreased when cerebral/cerebellar uptake ratio difference from baseline SPECT to ACZ-SPECT was greater than 2SD of normal control values. Results: Decreased vasoreactivity was observed in 38% (8/21), perfusion defect in 81% (17/21), and vasospasm in 38% (8/21). The preserved vasoreactivity group showed better outcome scale (92%, 12/13) and the decreased vasoreactivity group showed poorer outcome scale (62.5%, 5/8) (p=0.014). Extensive SAH was more frequently seen in the decreased vasoreactlvlty group (87.5%, 7/8) than in the preserved vasoreactivity group (30.7%, 4/13)(p=0.017). The perfusion defect and vasospasm did not show good correlation with outcome scale, extent of SAH, and Hunt-Hess grading (p=ns). Vasoreactivity represented the patient's outcome better than the vasospasm in all of the vasoreactivity/vasospasm-mismatched cases (6 cases). Conclusions: Our data show that decreased vasoreactivity on ACZ-SPECT does not always represent vasospastic condition. But patients with decreased vasoreactivity reveal poorer outcome than patients with angiographic vasospasm do. Therefore ACZ-SPECT is a valuable, noninvasive test for predicting the prognosis of patients with aSAH.

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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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