• The Journal of Korean Medicine
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• v.19 no.2
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• pp.59-74
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• 1998

Clinical observation was done on 272 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1997. 1. The cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage. and transient ischemic attack. The most case of them was the cerebral infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension. and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 7. The common symptoms were motor disability and verbal disturbance. 8 The average time to start physical therapy was 1l.3rd day after stroke in cerebral infarction and it was 15.2th day after stroke in cerebral hemorrhage. 9. The common complications were urinary tract infection, pneumonia, myocardial infarction. 10. Hypercholesterolemia and hypertriglyceridemia are usually found more frequently in cerebral infarction than in hemorrhage. 11. In acute or subacute stage, the methods of smoothening the flow of ki(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. and in recovering stage, the methods of replenishing ki(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.197-200
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• 2005

Objective: Ultrasound can be used in the treatment of large intracerebral hematoma. The authors present our experiences with Ultrasound-guided catheter placement for lysis and drainage of ganglionic hematoma, with emphasis on technical aspects. Methods: The authors applied real-time ultrasonography for the aspiration of intracerebral hematoma in 6cases. Ultrasound-guided aspiration via a burrhole was performed under local anesthesia. We selected a temporal entry point instead of the frequently used precoronal approach in ganglionic hematoma. A burrhole was made 4 to 6cm posterior from posterior border of frontal process of the zygomatic bone at the level of 4 to 5cm above the external auditory meatus. Results: In all patients, the catheter was placed accurately into the hematoma target. All patients were irrigated with urokinase once to three times a day. The catheter could be removed within two or three days. The mean hematoma volume was reduced from initially 32mL to 5mL in an average of two days. There were no intraoperative complications related to the use of real-time ultrasonography and no postoperative infections were noted. Conclusion: Ultrasound allows an easy and precise localization of the hematoma and the distance from the surface to the target can be calculated. Ultrasound-guided catheter placement for fibrinolysis and hematoma drainage is a simple and safe procedure.

• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.306-309
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• 2016

Using diffusion tensor tractography (DTT), we demonstrated injury of the arcuate fasciculus (AF) in the nondominant hemisphere in two patients who showed subfalcine herniation after intracerebral hemorrhage (ICH) in the dominant hemisphere. Two patients (patient 1 and patient 2) with ICH and six age-matched control patients who have ICH on the left corona radiata and basal ganglia without subfalcine herniation were recruited for this study. DTT was performed at one month after onset in patient 1 and patient 2. AFs of both hemispheres in both patients were disrupted between Wernicke's and Broca's areas. The fractional anisotropy value and tract numbers of the right AFs in both patients were found to be more than two standard deviations lower than those of control patients. In contrast, the apparent diffusion coefficient value was more than two standard deviations higher than those of control patients. Using the configuration and parameters of DTT, we confirmed injury of the AF in the nondominant hemisphere in two patients with subfalcine herniation following ICH in the dominant hemisphere. Therefore, DTT would be a useful tool for detection of underlying injury of the AF in the nondominant hemisphere in patients with subfalcine herniation.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.999-1006
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• 2019

Objectives: The purpose of this study was to report the improvement of symptoms by Korean medicine in acute hemorrhagic infarction. Method: The patient was diagnosed with a cerebral infarction of the right temporal lobe accompanied by cerebral hemorrhage of the left basal ganglia. He did not receive intravenous thrombolytic treatment. Sunghyangjungi-san-gamibang was initially administered, and Gami-daebo-tang was administered during the recovery phase, together with Uhwangchungsim-won, Simjeok-hwan, and acupuncture. The prognostic observation was conducted using the manual muscle test (MMT), the Korean version of the modified Bathel index (K-MBI), and subjective assessment. Results: After Korean medicine treatment, the K-MBI score was improved from 52 to 93. The MMT score and subjective assessment also showed improvement. Conclusions: For patients who cannot be treated with intravenous thrombolytic treatment, Korean medicine treatment is effective during the early and recovery stages of stroke.

• Korean Journal of Audiology
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• v.24 no.3
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• pp.157-160
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• 2020

A 38-year-old woman presented with a week's history of binocular horizontal double vision and acute vertigo with gaze-induced nystagmus. We considered a diagnosis of one of the six syndromes of the sixth cranial nerve and evaluated several causes. She had history of severe anemia, vitamin B12 deficiency, and hypertension. Magnetic resonance imaging with angiography showed stenosis of the right vertebral artery and hyperintensity on both basal ganglia. As we describe here, we should consider vertebrobasilar insufficiency as a cause for sixth cranial nerve palsy if a patient has high risk for microvascular ischemia, even in the absence of acute brain hemorrhage or infarction.

• Journal of Audiology & Otology
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• v.24 no.3
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• pp.157-160
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• 2020

A 38-year-old woman presented with a week's history of binocular horizontal double vision and acute vertigo with gaze-induced nystagmus. We considered a diagnosis of one of the six syndromes of the sixth cranial nerve and evaluated several causes. She had history of severe anemia, vitamin B12 deficiency, and hypertension. Magnetic resonance imaging with angiography showed stenosis of the right vertebral artery and hyperintensity on both basal ganglia. As we describe here, we should consider vertebrobasilar insufficiency as a cause for sixth cranial nerve palsy if a patient has high risk for microvascular ischemia, even in the absence of acute brain hemorrhage or infarction.

• The Journal of the Society of Stroke on Korean Medicine
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• v.16 no.1
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• pp.103-109
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• 2015

This report is about a case of monocular partial oculomotor nerve palsy in a patient with midbrain hemorrhage. The patient developed diplopia while driving. The Brain MRI film demonstrated a hemorrhage in the right midbrain and left corona radiata and microbleedings in both cerebral and cerebellar hemispheres, basal ganglia, midbrain, pons. We used Korean medicine treatment modalities including acupuncture, electroacupuncture, pharmacoacupuncture and herb medicines. As a result, limitation of upward gaze was recovered to about 90% of normal range.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.867-874
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• 2023

Introduction: Chronic subdural hemorrhage (CSDH) primarily affects the elderly, and its incidence is rising due to aging trends. Although burr-hole craniostomy is a common treatment for CSDH, it often has a high recurrence rate and can sometimes result in poor outcomes. Oryeong-san, a traditional Korean medicine, is emerging as a potential remedy, with documented cases in both Korea and Japan. Case Presentation: In March 2021, a patient was diagnosed with an intracerebral hemorrhage in the left basal ganglia. A subsequent brain computed tomography in June 2022 revealed CSDH. Given the potential need for surgery if no CSDH absorption occurred, the patient was treated with Oryeong-san. Later computed tomography scans indicated that surgery was no longer necessary. Conclusions: This study evaluated the efficacy of Oryeong-san in treating CSDH. The results demonstrated complete CSDH absorption with no observed side effects, highlighting Oryeong-san as a promising and safe therapeutic option.

• Journal of Korean Neurosurgical Society
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• v.30 no.2
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• pp.207-210
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• 2001

Objective : The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. Material and Method : A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. Results : In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. Conclusion : It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.109-115
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• 2009

Objective: The decision to adopt a conservative or surgical modality for a relatively small volume of spontaneous intracerebral hemorrhage (SICH) is difficult and often controversial, especially when consciousness is tolerable. The authors examined the results of stereotactic-guided evacuation of SICH for relatively small volumes with respect to functional outcome. Methods: This prospective study was performed on 387 patients with SICH who underwent stereotactic-guided evacuation (n = 204, group A) or conservative treatment (n = 183, group B) during the past 8 years. The primary end-point was recovery of functional status, which was estimated using the Modified Barthel Index (MBI) and the modified Rankin Scale (mRS). Results: All patients had a Glasgow coma scale (GCS) score of $\geq$ 13 and unilateral hemiparesis of less than motor power grade 3. Group demographic characteristics and initial neurological statuses were similar. In all cases, the volume of SICH involved was < 30 cm$^3$ and location was limited to basal ganglia and thalamus. At 6-month follow-ups, MBI was 90.9 in group A and 62.4 in group B (p < 005), and MRS was 1.2 in group A and 3.0 in group B (p < 0.05). Better motor function and stereotactic-guided evacuation had a significant effect on a functional recovery in regression analyses. Conclusion: Even in patients with a small volume of SICH, stereotactic-guided evacuation improved functional recovery in activities in daily life than conservative treatment did.