• Title/Summary/Keyword: Brain Hemorrhage

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A Case of Temporal Intracerebral Hemorrhage That Presented with Sudden Bilateral Hearing Loss as the Initial Symptom

  • Mun, Seog-Kyun;Hong, Young-Ho;Kang, Suk-Hyung;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.438-440
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    • 2010
  • A 57-year-old man presented to the outpatient department with sudden bilateral hearing loss. The otological examination suggested bilateral severe sensorineural hearing loss. After several hours, the patient complained of a headache and became drowsy. The brain computed tomography showed a $3{\times}4\;cm$ intracerebral hemorrhage (ICH) of the left temporal lobe. Surgery was performed and 34 days after the procedure the patient was discharged from the hospital with severe bilateral sensorineural hearing loss (SNHL). Temporal lobe ICH should be considered in the differential diagnosis of patients with sudden bilateral hearing loss, regardless of the other neurological symptoms.

Severe Hypothermia Accompanying Acute Subdural Hemorrhage

  • Kim, Jung-Goan;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.39 no.3
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    • pp.228-230
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    • 2006
  • Hypothermia is relatively a common condition and most cases involve mild hypothermia. But severe hypothermia below $30^{\circ}C$ is medical an emergency condition. We report the case of a 41-year-old man who had been left in a manhole for more than 9 hours on a freezing cold water. He was transported to our emergency room in semicomatose state with a body temperature $26.5^{\circ}C$. The patient was warmed with active rewarming. After initial stabilization, the patient was taken for a brain computed tomography and found to have large fronto-temporo-parietal[FTP] subdural hemorrhage. The patient underwent an emergent decompressive craniectomy and hematoma evacuation. After surgery, he recovered to drowsy mentation and vital signs were stable.

Traumatic Aneurysm of the Callosomarginal Artery-Cortical Artery Junction from Penetrating Injury by Scissors

  • Kim, Myoung Soo;Sim, Sook Young
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.222-225
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    • 2014
  • Traumatic intracranial aneurysms (TICAs) are rare and are associated with high rates of morbidity and mortality. TICAs usually result from head injuries caused by traffic accidents, industrial accidents, or gunshots. We report a traumatic aneurysm of the callosomarginal artery-cortical artery junction arising from a penetrating injury by scissors. A 51-year-old woman was admitted to our hospital after suffering a penetrating injury caused by scissors. Computed tomography (CT) and CT-angiography demonstrated a right orbital roof fracture, subarachnoid hemorrhage, frontal lobe hemorrhage, intraventricular hemorrhage, and a traumatic aneurysm of the right callosomarginal artery-cortical artery junction. We trapped the traumatic aneurysm and repositioned a galeal flap. Postoperative CT showed a small infarction in the left frontal lobe. Follow-up angiography two months later showed no residual aneurysm. We suggest that an aggressive surgical intervention be performed whenever TICA is diagnosed.

Direct Removal of Fourth Ventricle Hematoma in Massive Intraventricular Hemorrhage

  • Kim, You-Sub;Ryu, Han-Seung;Kim, Tae-Sun;Joo, Sung-Pil
    • Journal of Korean Neurosurgical Society
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    • v.65 no.2
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    • pp.325-330
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    • 2022
  • Various grading systems and surgical techniques have been developed for the treatment of intraventricular hemorrhage (IVH); however, little attention has been paid to the fourth ventricle hematoma. Nonetheless, hemorrhagic dilation of the fourth ventricle may lead to catastrophic consequences for patients with massive IVH. We present two cases of massive IVH accompanied by massive fourth ventricle hematoma which was successfully removed with combination of suboccipital craniotomy for fourth ventricle hematoma and intraventricular fibrinolysis for supratentorial hematoma.

Temporary Surgical Management of Intraventricular Hemorrhage in Premature Infants

  • Eun-Kyung Park;Ja-Yoon Kim;Dong-Seok Kim;Kyu-Won Shim
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.274-280
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    • 2023
  • Post-hemorrhagic hydrocephalus (PHH) in preterm infant is common, life-threatening and the main cause of bad developmental outcomes. Ventriculoperitoneal (VP) shunt is used as the ultimate treatment for PHH. Low birth weight and low gestational age are the combination of worse prognostic factors while the single most important prognostic factor of VP shunting is age. Aggressive and early intervention have better effect in intraventricular hemorrhage and intracranial pressures control. It reduces infection rate and brain damage resulted in delayed shunt insertion. It is extremely important to let PHH infants get older and gain weight to have internal organs to be matured before undergoing VP shunt. As premature infants undergo shunt after further growth, shunt-related complications would be reduced. So temporary surgical intervention is critical for PHH infants to have them enough time until permanently shunted.

The Long-Term Outcome and Rehabilitative Approach of Intraventricular Hemorrhage at Preterm Birth

  • Juntaek Hong;Dong-wook Rha
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.289-297
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    • 2023
  • Technological advances in neonatology led to the improvement of the survival rate in preterm babies with very low birth weights. However, intraventricular hemorrhage (IVH) has been one of the major complications of prematurity. IVH is relevant to neurodevelopmental disorders, such as cerebral palsy, language and cognitive impairments, and neurosensory and psychiatric problems, especially when combined with brain parenchymal injuries. Additionally, severe IVH requiring shunt insertion is associated with a higher risk of adverse neurodevelopmental outcomes. Multidisciplinary and longitudinal rehabilitation should be provided for these children based on the patients' life cycles. During the infantile period, it is essential to detect high-risk infants based on neuromotor examinations and provide early intervention as soon as possible. As babies grow up, close monitoring of language and cognitive development is needed. Moreover, providing continuous rehabilitation with task-specific and intensive repetitive training could improve functional outcomes in children with mild-to-moderate disabilities. After school age, maintaining the level of physical activity and managing complications are also needed.

Unusual Cause of Cognitive Impairment after a Traffic Accident (교통사고 후 발생한 드문 원인에 의한 인지 장애 1예)

  • Park, Chi-Min
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.151-154
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    • 2011
  • In trauma patients, cognitive impairment may develop due to several causes: traumatic brain injury such as intracranial hemorrhage, diffuse axonal injury, hypoxic brain injury or reperfusion injury, the psychologic disorder, such as acute stress disorder, post-traumatic disorder or delirium. We describe a 62-year-old male with post-trauma cognitive impairment due to a primary central nervous system lymphoma.

Study on Prognostic Factors using Computerized Tomographic Findings and Ability in daily Life(ADL) Evaluation in Patients with Hypertensive Intracerebral Hemorrhage (고혈압성(高血壓性) 뇌출혈(腦出血) 환자(患者)의 Brain-CT소견과 일상생활능력(ADL)평가를 통한 예후인자에 대한 고찰)

  • Jung, Seung-Hyun;Shin, Gil-Cho;Lee, Won-Chul
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.87-100
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    • 1997
  • Clinical Observation was made on 29 cases of Hypertensive intracerebral hemorrhage patients in the ICU of In-Chon Oriental Medical Hosptital of Dongguk University from October in 1994 to June in 1996. The observation are ability in daily life(ADL) of patients by Location and Type of Hemorrhage, Amounts of Hematoma, Graeb's Score, Intraventricular Hemorrhage, States 4th Ventricle, Surrounding Edema around the Hematoma, Middle Line Shift, Age, Level of Consciousness. Pupillary Light Reflex and Treatment Modalities. Our conclusions on Prognostic Factors using Computerized Tomographic Findings and Ability in daily Life(ADL) Evaluation in patients with Hypertensive Intracerebral Hemorrhage Patients are as follows. A variety of prognostic factors that influence ADL5+6(%) were observed. 1. ADL5+6($\%$) of total cases was 34.9%. The prognosis were unfavorable when high Graeb score(P<0.05), dilated 4th ventricle(P<0.01), much surrounding edema around the hematoma (P<0.05), unilateral unreactive or both unreactive pupillary light reflex(P<0.05). 2. There was no difference of ADL5+6(%) in both hypertensive basal ganglionic and thalamic intracerebral hemorrhage. 3. The prognosis gets poorer as the volume of hematoma is more than 16cc. But there was no difference of ADL5+6(%) in each group. 4. The prognosis gets poorer in cases with IVH than without IVH. But there was no difference of ADL5+6(%) in each group. 5. The prognosis gets poorer as the middle line shift is more than 6mm. But there was no. difference of ADL5+6(%) in each group. 6. The prognosis gets poorer as the level of consciousness is more than drowsy. But there' was no difference of ADL5+6(%) in each group.

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Remote Cerebral and Cerebellar Hemorrhage after Massive Cerebrospinal Fluid Leakage

  • You, Sung-Hye;Son, Kyu-Ri;Lee, Nam-Joon;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.240-243
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    • 2012
  • Dural tears can occur during spinal surgery and may lead to cerebrospinal fluid (CSF) leakage which is rarely involved in remote cerebellar hemorrhage. Only a few of cases of simultaneous cerebral and cerebellar hemorrhage have been reported in the English literature. We experienced a case of multiple remote cerebral and cerebellar hemorrhages in a 63-year-old man who exhibited no significant neurologic deficits after spinal surgery. Magnetic resonance imaging (MRI) performed 4 days after the surgery showed a large amount of CSF leakage in the lumbosacral space. The patient underwent the second surgery for primary repair of the dural defect, but complained of headache after dural repair surgery. Brain MRI taken 6 days after the dural repair surgery revealed multifocal remote intracerebral and cerebellar hemorrhages in the right temporal lobe and both cerebellar hemispheres. We recommend diagnostic imaging to secure early identification and treatment of this complication in order to prevent serious neurologic deficits.

Recurrent Spontaneous Intracerebral Hemorrhage

  • Lee, Chang-Ju;Koh, Hyeon-Song;Choi, Seung-Won;Kim, Seon-Hwan;Yeom, Jin-Young;Kim, Youn
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.425-430
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    • 2005
  • Objective : Recently, the survival rate and prognosis of spontaneous intracerebral hemorrhage[S-ICH] has improved, and their enhanced survival has become associated with a consequent rise in the recurrence of S-ICH. The aim of this study is to improve the prevention of recurrent S-ICH. Methods : Between January 1999 and March 2004, we experienced 48 cases of recurrence. We classified the patients into the two groups; a double ICH group and a triple ICH group. We investigated their brain CTs, MRIs, cerebral angiographies, and medical records, retrospectively. Results : Majority of patients had the intervals at least 12 months, and most of patients underwent conservative treatment. The most common hemorrhage pattern of recurrence was ganglionic-ganglionic [basal ganglia - basal ganglia], and the second attack was contralateral side of the first attack in a large percentage of all patients. Prognosis of patients was worsened in recurrent attack. Nearly all patients had medical history of hypertension, and most patients have taken antihypertensive medication at the arrival of emergency room. Conclusion : In treating hypertension for S-ICH patients, we stress that blood pressure must be thoroughly controlled over a long period of time.