• Title/Summary/Keyword: Brain Lesion

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Effects of Positioning Education Program through Oral Explanations or Brochures for Parents of Premature Infants with Brain Lesions and the Satisfaction Level of Physical Therapy at Discharge

  • Lee, Hye-Young;Kang, Dong-Yeon
    • The Journal of Korean Physical Therapy
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    • v.29 no.5
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    • pp.259-264
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    • 2017
  • Purpose: This study examined the effects of a positioning education program through the brochure or oral explanations for the parents of premature infants with a brain lesion and investigated the satisfaction level of physical therapy of parents of premature infants with a brain lesion. Methods: Forty parents of premature infants with a brain lesion participated in this study. The recruited premature infants were randomized into groups A (n=20) and B (n=20) for the purpose of the positioning education method through brochure or oral explanations. The level of satisfaction and recognition for the positioning education program was investigated by the parents of 12 month old infants. The gross motor function, measure-88, was examined at three months, six months, nine months, and twelve months of the corrected age. Results: No significant differences in the recognition of the position education program, level of satisfaction of the environment, and the attitude of the therapist were noted (p>0.05). Significantly high levels of satisfaction with the program of group B given the brochure were noted. The gross motor function measure-88 was also similar in both groups (p<0.05). Conclusion: This study suggests that the parents were satisfied with the positioning education program of the brochure. The differences in educational methods did not affect the development of premature infants.

Lesion of Subthalamic Nucleus in Parkinsonian Rats : Effects of Dopamine $D_1$ and $D_2$ Receptor Agonists on the Neuronal Activities of the Substantia Nigra Pars Reticulata

  • Park, Yong-Sook;Jeon, Mi-Fa;Lee, Bae-Hwan;Chang, Jin-Woo
    • Journal of Korean Neurosurgical Society
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    • v.42 no.6
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    • pp.455-461
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    • 2007
  • Objective : It was hypothesized that dopamine agonist administration and subthalamic nucleus (STN) lesion in the rat might have a synergistic effect on the neuronal activities of substantia nigra pars reticulata (SNpr) as observed in patients with Parkinson's disease. The effects of SKF38393 (a $D_1$ receptor agonist) and Quinpirole (a $D_2$ receptor agonist) were compared in parkinsonian rat models with 6- hydroxydopamine (6-OHDA) after STN lesion. Methods : SKF38393 and Quinpirole were consecutively injected intrastriatally. SNpr was microrecorded to ascertain the activity of the basal ganglia output structure. The effect of SKF38393 or Quinpirole injection on the firing rate and firing patterns of SNpr was investigated in medial forebrain bundle (MFB) lesioned rats and in MFB+STN lesioned rats. Results : The administration of SKF38393 decreased SNpr neuronal firing rates and the percentage of burst neurons in the MFB lesioned rats, but did not alter them in MFB+STN lesioned rats. The administration of Quinpirole significantly decreased the spontaneous firing rate in the MFB lesioned rats. However, after an additional STN lesion, it increased the percentage of burst neurons. Conclusion : This study demonstrated that dopamine agonists and STN lesion decreased the hyperactive firing rate and the percentage of burst neurons of SNpr neurons in 6-OHDA lesioned rats, respectively. Quinpirole with STN lesion increased a percentage of burst neurons. To clear the exact interactive mechanism of $D_1$ and $D_2$ agonist and the corresponding location, it should be followed a study using a nonselective dopamine agonist and $D_1$, $D_2$ selective antagonist.

Extracranial systemic antitumor response through the abscopal effect induced by brain radiation in a patient with metastatic melanoma

  • D'Andrea, Mark A.;Reddy, G.K.
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.302-308
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    • 2019
  • The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

A Case of Thyroid Papillary Carcinoma Metastasizing to the Brain (뇌 전이를 보인 갑상선 유두암 1예)

  • Yoon Jung-Han;JaeGal Young-Jong;Kim Jae-Hwu;Kim Sae-Jong
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.235-240
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    • 1996
  • Brain metastasis is extremely rare in thyroid papillary carcinoma which has an indolent clinical course and results in good prognosis. A 24-year-old man presenting with seizure attack is described. He had been treated under the diagnosis of thyroid papillary carcinoma with total thyroidectomy, postoperative internal radiation with radioactive iodine, and thyroid hormone replacement. Although $^{99m}$Tc brain spect and $^{131}$I whole body scan did not revealed any significant lesion, brain CT and MRI showed lcm sized mass in frontal lobe. Stereotactic craniotomy and removal of the tumor, which was histologically proven metastatic lesion from thyroid papillary carcinoma, was done with satisfactory improvement.

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2 Cases of Lower Limb Monoplegia due to Brain Cortical Infarction (대뇌 피질 경색으로 인한 하지 단마비 환자 한방치험 2례)

  • Shin, Jung-Ae;Son, Dong-Hyuk;Yu, Kyung-Suk;Lee, Jin-Goo;Lee, Young-Goo
    • The Journal of Internal Korean Medicine
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    • v.22 no.2
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    • pp.263-269
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    • 2001
  • Monoplegia is the paralysis of either the upper or lower limb. Monoplegia is commonly caused by an injury to the cerebral cortex; it is rarely caused by an injury to the internal capsule, brain stem, or spinal cord. Most cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. According to motor homunculus, lower limb monoplegia occurs from limited damage to the most upper part of the primary motor area(Brodmann's area 4, located in precentral gyrus). Clinically, lower limb monoplegia due to brain cortical infarction is commonly misunderstood as monoplegia due to spinal injury because the lesion is situated at the most upper part of precentral gyrus. We had many difficulties in finding lesion on brain CT, but we diagnosed two patients correctly by using an MRI, who have lower limb monoplegia due to brain cortical infarction oriental treatment.

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Changes of Motor Deactivation Regions in Patients with Intracranial Lesions

  • Lee, Seung Hwan;Koh, Jun Seok;Ryu, Chang-Woo;Jahng, Geon Ho
    • Journal of Korean Neurosurgical Society
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    • v.54 no.6
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    • pp.453-460
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    • 2013
  • Objective : There is a rich literature confirming the default mode network found compatible with task-induced deactivation regions in normal subjects, but few investigations of alterations of the motor deactivation in patients with intracranial lesions. Therefore, we hypothesized that an intracranial lesion results in abnormal changes in a task-induced deactivation region compared with default mode network, and these changes are associated with specific attributes of allocated regions. Methods : Blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) during a motor task were obtained from 27 intracranial lesion patients (mean age, 57.3 years; range 15-78 years) who had various kinds of brain tumors. The BOLD fMRI data for each patient were evaluated to obtain activation or deactivation regions. The distinctive deactivation regions from intracranial lesion patients were evaluated by comparing to the literature reports. Results : There were additive deactivated regions according to intracranial lesions : fusiform gyrus in cavernous hemangioma; lateral occipital gyrus in meningioma; crus cerebri in hemangiopericytoma; globus pallidus, lateral occipital gyrus, caudate nucleus, fusiform gyrus, lingual gyrus, claustrum, substantia nigra, subthalamic nucleus in GBM; fusiform gyrus in metastatic brain tumors. Conclusion : There is increasing interest in human brain function using fMRI. The authors report the brain function migrations and changes that occur in patients with intracranial lesions.

Intracranial Bone Formation - A Case Report - (두개강내에서 발견된 골 조직 - 증 례 보 고 -)

  • Lyo, In Uk;Suh, Jae Hee;Kim, Young
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.78-80
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    • 2001
  • The bone formation accompanied with other diseases in brain has been rarely reported. Furthermore, it has not been reported without any specific disease. We report a case of a 27 year old female who was referred to our hospital because of the incidentally found calcified lesion in plain X-ray of the skull. The CT and MRI of the brain showed a calcification with minimal enhancement at left parietal area. The calcified lesion was removed and biopsy was performed with stereotactic guided craniotomy. Pathologically, the lesion was confirmed as the membranous bone which was composed of bony trabeculations with osteocytes and the biopsy from adjacent area to the bone revealed a gliosis without any other disease.

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Unexpected Seizure Attack in a Patient with Spinal Metastasis Diagnosed as Posterior Reversible Encephalopathy Syndrome

  • Kim, Chang-Hyoun;Kim, Chi-Heon;Chung, Chun-Kee;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • v.50 no.1
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    • pp.60-63
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    • 2011
  • Seizure is a foreseeable risk in patients with brain lesion. However, seizure during treating non-brain lesion is not a familiar situation to neurosurgeon. Posterior reversible encephalopathy syndrome (PRES) is a relatively common situation after systemic chemotherapy. The aim of this study is to make neurosurgeons aware of this potential medical problem. A 52-year-old woman with advanced gastric cancer, presented with low back pain due to spinal metastasis at the 4th lumbar vertebra. Ten cycles of chemotherapy with FOLFOX (5-Fluoruracil/Oxaliplatin) had been completed 23 days ago. Two days before the planned operation, a generalized tonic clonic seizure occurred. She did not have a history of hypertension or seizure. The seizure was stopped with lorazepam 4mg. The brain magnetic resonance (MR) imaging showed high signal changes in both parieto-occipital lobes on the T2-weighted images, and these were partially enhanced, suggesting PRES. The surgery was preceded by treatment with an antiepileptic drug. The MR images, taken 1.5 months after the seizure, showed that the lesion was no longer present. At 3 month follow-up, no additional seizure attack occurred without any seizure medication. The possibility of a seizure attack should be considered if the patient has a history of chemotherapy.

Glioblastoma Mimicking Herpes Simplex Encephalitis

  • Nam, Tai-Seung;Choi, Kang-Ho;Kim, Myeong-Kyu;Cho, Ki-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.50 no.2
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    • pp.119-122
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    • 2011
  • We report a case of 70-year-old man with glioblastoma presenting as acute encephalitic illness. The patient exhibited sudden onset of cognitive impairment and headache for 2 days. Initial brain MRI showed left temporal lobe hyperintensity, and cerebrospinal fluid cytology revealed a mild pleocytosis. The patient had initially improved after medical treatment with a presumptive diagnosis of herpes simplex encephalitis (HSE). After 8 months, the patient complained of recurrent seizures. A follow-up brain MRI revealed marked increases in size and surrounding perilesional edema in the left temporal lesion on T2-weighted images and a new contrast-enhancing lesion on gadolinium-enhanced T1-weighted images. Stereotactic brain biopsy revealed a glioblastoma. The atypical encephalitic presentation of glioblastoma should be considered if definitive evidence for the diagnosis of HSE cannot be obtained.

Patients with brain metastases the usefulness of contrast-enhanced FLAIR images after delay (뇌전이 환자의 조영 증강 후 지연 FLAIR 영상의 유용성)

  • Byun, Jae-Hu;Park, Myung-Hwan;Lee, Jin-Wan
    • Korean Journal of Digital Imaging in Medicine
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    • v.16 no.1
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    • pp.13-19
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    • 2014
  • Purpose: FLAIR image is beneficial for the diagnosis of various bran diseases including ischemic CVS, brain tumors and infections. However the border between the legion of brain metastasis and surrounding edema may not be clear. Therefore, this study aims to investigate the practical benefits of delayed imaging by comparing the image from a patient with brain metastasis before a contrast enhancement and the image 10 minutes after a contrast enhancement. Materials and methods: Of the 92 people who underwent MRI brain metastases in suspected patients 13 people in three patients there is no video to target the 37 people confirmed cases, and motion artifacts brain metastases in our hospital June-December 2013, 18 people measurement position except for the three incorrect patient (male: 11 people, female: 7 people, average age: 60 years) in the target, test equipment, 3.0T MR System (ACHIEVA Release, Philips, I was 8ChannelSENSE Head Coil use Best, and the Netherlands). TR 11000 ms, TE 125 ms, TI2800 ms, Slice Thickness 5 mm, gap 5 mm, is a Slice number 21, the parameters of the 3D FFE, T2 FLAIR variable that was used to test, TR 8.1 ms, TE 3.7 ms, Slice number 240 I set to. The experiment was conducted by acquiring the FLAIR prior to contrast enhancement (heretofore referred to as Pre FLAIR), and acquiring the 3D FFE CE five minutes after the contrast enhancement, and recomposing the images in an axial plane of S/T 3mm, G 0mm (heretofore referred to as MPR TRA CE). Using the FLAIR 10 minutes after the contrast enhancement (heretofore referred to as Post FLAIR) and Pi-View, a retrospective study was conducted. Using MRIcro on the image of a patient confirmed for his diagnosis, the images before and after the contrast media, as well as the CNR and SNR of the MPR TRA CE images of the lesion and the site absent of lesion were compared and analyzed using a one-way analysis of variance. Results: CNR for Pre FLAIR and Post FLAIR were 34.35 and 60.13, respectively, with MPR TRA CE at 23.77 showing no significant difference (p<0.050). Post-experiment analysis shows a difference between Pre FLAIR and Post FLAIR in terms of CNR (p<0.050), but no difference in CNR between Post FLAIR and MPR TRA CE (p>0.050), indicating that the contrast media had an effect only on Pre FLAIR and Post FLAIR. The SNR for the normal site Pre FLAIR was 106.43, and for the lesion site 140.79. Post FLAIR for the normal site was 107.79, and for the lesion site 167.91. MPR TRA CE for the normal site was 140.23 and for the lesion site 183.19, showing significant difference (p<0.050), and post-experiment analysis shows that there was a difference in SNR only on the lesion sites for Pre FLAIR and Post FLAIR (p<0.050). There was no difference in SNR between the normal site and lesion site for Post FLAIR and MPR TRA CE, indicating no effect from the contrast media (p>0.050). Conclusions: This experiment shows that Post FLAIR has a higher contrast than Pre FLAIR, and a higher SNR for lesions, It was not not statistically significant and MPR TRA CE but CNR came out high. Inspection of post-contrast which is used in a high magnetic field is frequently used images of 3D T1 but, since the signal of the contrast medium and the blood flow is included, this method can be diagnostic accuracy is reduced, it is believed that when used in combination with Post FLAIR, and that can provide video information added to the diagnosis of brain metastases.

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