• Journal of Korean Neurosurgical Society
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• 제58권5호
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• pp.471-475
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• 2015

Intracerebral hemorrhage (ICH) is common among various types of storkes; however, it is rare in young patients and patients who do not have any risk factors. In such cases, ICH is generally caused by vascular malformations, tumors, vasculitis, or drug abuse. Basal ganglia ICH is rarely related with distal lenticulostriate artery (LSA) aneurysm. Since the 1960s, a total of 29 distal LSA aneurysm cases causing ICH have been reported in the English literature. Despite of the small number of cases, various treatment methods have been attempted : surgical clipping, endovascular treatment, conservative treatment, superficial temporal artery-middle cerebral artery anastomosis, and gamma-knife radiosurgery. Here, we report two additional cases and review the literature. Thereupon, we discerned that young patients with deep ICH are in need of conventional cerebral angiography. Moreover, initial conservative treatment with follow-up cerebral angiography might be a good treatment option except for cases with a large amount of hematoma that necessitates emergency evacuation. If the LSA aneurysm still persists or enlarges on follow-up angiography, it should be treated surgically or endovascularly.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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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.

• Journal of Korean Neurosurgical Society
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• 제37권4호
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• pp.300-302
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• 2005

The authors report a case of hyperacute, massive hemorrhage in the left basal ganglia with severe midline shift that was treated successfully by the ultrasound-monitored free hand aspiration technique. Every effort was made to shorten time until removal of considerable amount of the hematoma and minimize duration of cerebral herniation, avoiding additional irreversible neurological deficit. A burr hole aspiration technique was preferred to standard craniotomy procedure, and any time-consuming procedures such as stereotactic frame application were abandoned. A burr hole was localized on the basis of computed tomography images simply and quickly with a ruler, and safety of the aspiration procedure was augmented by real-time ultrasound monitoring. Such minimally invasive technique relieved cerebral herniation successfully while avoiding time consumption and the morbidity of major craniotomy procedure. Early resuscitation of the patient with cerebral herniation in this case resulted in excellent recovery of the patient's neurological deficit. The patient's mentality started to improve rapidly and was clear six months after the surgery.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.81-83
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• 2006

Periodic lateralized epileptiform discharges(PLEDs) are usually seen in acute and subacute cerebral lesions. Occasionally PLEDs could be observed in persistent structural lesions. We observed PLEDs-plus in a patient with right basal ganglionic hemorrhage, at 10 months and 13 months after the stroke. The patients suffered two seizures 3 months and 5 days before recording of EEG. PLEDs-plus may persist as an interictal abnormal finding and the rhythmic discharge of that may be increased by a seizure.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 1997년도 제36차 춘계학술대회 초록집
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• pp.148-148
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• 1997

• Journal of Korean Neurosurgical Society
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• 제49권2호
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• pp.112-115
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• 2011

The intra-arterial administration of nimodipine (IAN) is commonly used for cerebral vasospasm refractory to medical treatments. We report two cases of vasogenic edema after IAN. Our patients with aneurismal subarachnoid hemorrhage presented with vasospasm, which was treated by IAN. Consequently, vasogenic edema developed in the basal ganglia. Reperfusion following IAN for vasospasm may have the potential for inciting vasogenic edema in the ischemic brain.

• 대한한방내과학회지
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• 제19권1호
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• pp.168-184
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• 1998

Clinical Observation was made on 120 Cases of CVA that were confirmed through brain CT of Oriental Medical hospital of Se-Myung University from July in 1997 to June in 1998. 1. The CVA cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), and the greatest in number among them were the cases of cerebral infarction. 2. The most cases were 50 of age in all cases, in cerebral infarction were over 70 of age. There is no significant difference in the frequency of strokes between the male and female. the ratio was 1.07 : 1. 3. The frequency of strokes seems to have no relation to month and season. 4. The course of entering hospital, most patients visited this hospital directly(not through any other hospital) within 24hours. 5. The first attack was noted in 80.8%, the recurrance attack in 19.2% and the cerebral infarction had high recurrance ratio compared with cerebral hemorrhage. 6. The average duration of hospitalization was 25.2 days. 7. The most ordinary preceding disease was hypertension. 8. The common symptoms were motor disturbance and dysphasia. 9. The most frequent location of the lesion in cerebral infarction was parietal lobe, in cerebral hemorrhage was basal ganglia. 10. According to electrocardiography findings, abnormality was noted in cerebral infarction more than cerebral hemorrhage, subarachnoid hemorrhage. 11. The hypercholesterolemia and hypertriglyceridemia were found more frequently in cerebral infarction than cerebral hemorrhage, subarachnoid hemorrhage. 12. The average time to start physical theraphy was 7.76 days after admission. 13. The most common complications were pneumonia and bed sore.

• Journal of Korean Neurosurgical Society
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• 제49권5호
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• pp.287-289
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• 2011

Thalamoperforating artery aneurysms are rarely reported in the literature. We report an extremely rare case of ruptured distal anterior thalamoperforating artery aneurysm which was treated by endovascular obliteration in a patient with occlusion of both the internal carotid arteries (ICAs) : A 72-year-old woman presented with severe headache and loss of consciousness. Initial level of consciousness at the time of admission was drowsy and the Glasgow Coma Scale score was 14. Brain computed tomography (CT) scan was performed which revealed intracerebral hemorrhage in right basal ganglia, subarachnoid hemorrhage, and intraventricular hemorrhage. The location of the aneurysm was identified as within the globus pallidus on CT angiogram. Conventional cerebral angiogram demonstrated occlusion of both the ICAs just distal to the fetal type of posterior communicating artery and the aneurysm was arising from right anterior thalamoperforating artery (ATPA). A microcatheter was navigated into ATPA and the ATPA proximal to aneurysm was embolized with 20% glue. Post-procedural ICA angiogram demonstrated no contrast filling of the aneurysm sac. The patient was discharged without any neurologic deficit. Endovascular treatment of ATPA aneurysm is probably a more feasible and safe treatment modality than surgical clipping because of the deep seated location of aneurysm and the possibility of brain retraction injury during surgical operation.

• Investigative Magnetic Resonance Imaging
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• 제18권3호
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• pp.258-262
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• 2014

고혈압 뇌병증과 기저핵의 뇌출혈은 급성 고혈압에서 나타나는 의학적 응급상황이다. 고혈압 뇌병증과 뇌출혈의 관계는 밝혀져 있지 않지만 대량 출혈에 의한 뇌압상승은 쿠싱 반응을 일으켜 고혈압 뇌병증을 유발하거나 악화시킬 수 있을 것으로 추정된다. 이 보고는 뇌출혈과 동반하여 일어난 뇌간의 독립적인 고혈압 뇌병의증이라는 드문 사례를 기록한다.

• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.230-235
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• 2007

Objective : We investigated the incidence of the vascular abnormalities associated with spontaneous intracerebral hemorrhage [ICH] using three-dimensional computed tomographic angiography [3D-CTA]. Methods : We prospectively assessed consecutive 76 patients with spontaneous intracerebral hemorrhage [ICH] who underwent 3D-CTA between June 2003 and May 2005. The patients with a recent history of trauma or mainly subarachnoid hemorrhage were excluded. We investigated relationship between vascular abnormality and ICH location. The findings of 3D-CTA were classified as one of three patterns with ICH; type A [without evidence of vascular abnormality], type B [with no vascular abnormality as the source of hemorrhage, but with incidental vascular abnormality], and type C [presence of a vascular abnormality as the source of hemorrhage]. Results : Sites of ICH were lobar 26, basal ganglia 23, thalamus 17, posterior fossa 6 and dominant intraventricular hemorrhage [IVH] 4. Among 76 patients, sixteen [21.1%] vascular abnormalities were noted excluding 13 cases of stenoocclusive disease. Sixteen cases included 6 cases of cerebral aneurysms [7.9%], 5 moyamoya diseases [6.6%], 4 arteriovenous malformations [5.3%] and 1 dural sinus thrombosis [1.3%]. Lobar ICH [30.8%] had a higher vascular abnormalities than other types, and younger age [<40] group had a higher incidence of vascular abnormalities than old age group. The patterns of 3D-CTA include sixty cases [79.0%] of type A, 6 cases [7.8%] of type Band 10 cases [13.2%] of type C. The vascular abnormalities were found in 8 [13.5%] of 59 hypertensive patients and 8 [47.0%] of 17 non-hypertensive patients [p=0.006]. Conclusion : 3D-CT angiography is considered a useful screening tool for ICH patients with suspected cerebrovascular abnormalities and should be considered in such clinical settings, especially in lobar type and in non-hypertensive younger patients.