• Title/Summary/Keyword: Brain Stroke

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Postanesthetic Cerebral Infarction Following Neck Dissection -A case report - (경부청소술 마취 후 발생한 뇌경색 -증례 보고-)

  • Park, Chang-Joe;Lee, Jong-Ho;Kim, Myung-Jin;Kim, Hyun-Jeong;Yum, Kwang-Won
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.1 s.4
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    • pp.34-37
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    • 2003
  • Postoperative stroke is uncommon even in elderly patients, who have a higher incidence of all types of postoperative complications. The mechanism of postoperative stroke is not certain, but can be explained by intravascular clottings originated from thrombus or embolus or by intracranial hemorrhage. In a 66-year-old male patient with current hypertension medication, who underwent both neck dissection for malignancy metastasis under general anesthesia, the left hemiparesis and delayed emergency were found postoperatively. After transferred to intensive care unit, he got the thrombolytic therapy and then the therapies to decrease the swelling of the brain on the diagnosis of cerebral infarction in the vascular distribution of the middle cerebral artery. A brain MRI definitely showed the midline deviation to the left of the right brain hemisphere due to the progressing edematous changes. As he got worse, the emergency neurosurgical operation was proposed but rejected by his family. He died at postoperative 3 days. In this hypertensive patient. perioperative stroke could be originated from the surgical stimuli on major vessels, which were inevitable in neck dissection during the operation. We report this case of the postoperative stroke, which could be highly possible to be associated with extensive head and neck surgery.

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A Clinical Study about Distribution of Serum Lipid Density on Stroke Patients (졸중풍(卒中風) 환자(患者)에 있어 혈중지질(血中脂質)의 분포(分布) 상황(狀況)에 대한 임상적(臨床的) 고찰(考察))

  • Chou, Li-Shan;Jung, Hyun-Ji;Han, Chang-Ho;Yoo, Jae-Yeon
    • The Journal of Internal Korean Medicine
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    • v.21 no.4
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    • pp.583-590
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    • 2000
  • Objective : The major risk factors of stroke are hyperlipemia, ateriosclerosis, hypertension, diabetis mellitus, smoking, drinking, age, personal history, family history etc. Hypertension, smoking and hyperlipemia are very important factor to promote stroke. We intended to observe the serum lipid density of 51 patients come to Joongpoong & Chronic Disease Center of Conmaul Oriental hospital, comparing with already reported study. Methods : We studied 51 stroke-patients( 38 cerebral infarction, 13 intracerebral hemorrhage) of Conmaul Oriental hospital, Department of oriental internal medicine, Joongpoong & Chronic Disease Center from January 1. 1999 to August 31. 2000, which examined by neurologic test, brain-CT, brain-MRI. . We used DOSHISA TBA-30FR(Japan) as instrument for measuring total cholesterol and triglyceride of serum. Results and conclusions : The results are as follows 1. The rate of hyperlipemia and presumed-hyperlipemia is higher in female patient-group than male patient-group. 2. The rate of hyperlipemia and presumed-hyperlipemia is higher in drinking group than non-drinking group. 3. The rate of hyperlipemia and presumed-hyperlipemia is higher in hypertension group than normotention group.

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The Osteoporotic Condition as a Predictive Factor for Hemorrhagic Transformation in Acute Cardioembolic Stroke

  • Won, Yu Deok;Kim, Jae-Min;Ryu, Je-Il;Koh, Seong-Ho;Han, Myung-Hoon;Cheong, Jin-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.763-775
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    • 2021
  • Objective : Hemorrhagic transformation (HT) can be occurred after acute cerebral infarction. HT can worse symptoms in severe cases and adversely affect long-term prognosis. As bone and vascular smooth muscle are composed of type 1 collagen, we aimed to identify a potential relationship between bone mineral density (BMD) and HT after acute cardioembolic stroke. Methods : As an indicator of BMD, we used mean frontal skull Hounsfield unit (HU) values on brain computed tomography (CT). Multivariative hazard ratios were calculated using Cox regression analysis to identify whether the osteoporotic condition was an independent predictor of HT after acute cardioembolic stroke. Results : This 11-year analysis enrolled 506 patients who diagnosed as acute cardioembolic infarction. The first tertile of skull HU value was an independent predictor of HT development compared to the third tertile (hazard ratio, 2.12; 95% confidence interval, 1.13-3.98; p=0.020). We observed no interactions between age and skull HU with respect to HT statistically. Conclusion : The results of this study revealed an association between osteoporotic conditions and HT development after acute cardioembolic stroke. A convenient method to measure the cancellous bone HU value of the frontal skull using brain CT images may be useful for predicting HT in patients with acute cerebral infarction.

The Analysis of relation to brain iron deposition of Parkinson's Disease using Quantitative Susceptibility Mapping (정량적 자화율 맵핑을 통한 뇌 철분 침착과 파킨슨병의 연관성 분석)

  • Gyu-Ri Jeon;Han-Gyul Lee;Seung-won Kwon;Seung-Yeon Cho;Woo-Sang Jung;Sang-Kwan Moon;Jung-Mi Park;Chang-Nam Ko;Seong-Uk Park
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.150-164
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    • 2024
  • Objectives: This study aimed to investigate the levels of brain iron deposition in Parkinson's disease (PD) patients using Quantitative Susceptibility Mapping (QSM) and to determine whether distinctions compared to the general population exist. Furthermore, we examined potential variations in iron deposition among different PD subtypes. Methods: Structural brain imaging was conducted on 75 participants at Gangdong Kyung Hee University Hospital between August 2017 and May 2020. PD patients were categorized into Tremor Dominant (TD) and Postural Instability and Gait Difficulty (PIGD) subtypes. Voxel-based morphometry and QSM were employed to compare voxel-wise magnetic susceptibility across the entire brain between Normal Controls (NC) and PD groups. Subsequently, QSM values were compared between TD and PIGD groups. Results: QSM values were compared among 46 PD patients and 23 normal controls, as well as between TD (n=22) and PIGD (n=24) groups. Voxel-based QSM analysis revealed no significant differences between groups. Similarly, ROI-based QSM analysis showed no significant distinctions. Conclusions: No significant variations were observed between the PD patient group, NC group, or PD subtypes. This study systematically compared QSM values across a broad range of brain regions potentially linked to PD pathology. Additionally, the subdivision of the PD group into TD and PIGD subtypes for QSM-based iron deposition analysis represents a meaningful and innovative approach.

AN EXPLORATORY STUDY COMPARING BLOOD METAL CONCENTRATIONS BETWEEN STROKE AND NON-STROKE PATIENTS IN KOREANS

  • Lee, Sun-Dong;Ko, Seong-Gyu;Kim, Rok-Ho;Hu, Howard;Amarasiriwardena, Chitra J.;Park, Hae-Mo
    • Proceedings of the Korean Environmental Health Society Conference
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    • 2005.12a
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    • pp.87-94
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    • 2005
  • Results from previous studies revealed that metal level in the body is related to certain types of diseases. For example. serum copper level with chronic heart failure, iron and transferrin in the blood serum with acute cerebral vascular diseases, Zn in the CNS, lead with neurotoxicity, hypertension, genetic damage, arsenic with cancer skin lesion, Al with neurobehavioral function (cognitive impairment and memory disorder), and etc. The rate of stroke has increased in recent years and several metals were found to be responsible for causing stroke. This study compared several blood metal concentrations between stroke and non-stroke patients. Patients with stroke (116 samples) and non-stroke (111 samples including lowback pain and others) participated in this study. Total of 227 blood samples were collected and participants completed questionnaires regarding age, gender, occupation, residence, alcohol, smoking, and etc. To be qualified into the stroke group, patients have never experienced stroke previously. Subjects only included ischemic stroke and intracerebral hemorrhage patients diagnosed by brain CT and brain MRI. Patients with high risk of metal exposure such as herbal intake and job related exposure were excluded. 10ml of blood samples were analyzed by ICP-MS method at the Center of Nature and Science at Sangji University. Metal geometric mean (SD) concentrations in blood of study subjects showed higher values, 2.64-36.12%, than WHO reference values in Mn, Ni, Hg, Se, and As. Metal concentration in blood of stroke patients non-adjusted for potential confounders was higher except for Hg and also higher except for Ni in adjusted for potential confounders. Co was significantly higher in stroke patients (p=0.002) than non-stroke patients adjusted for potential confounders. Regression coefficient values of stroke patients was 0.17-8.25 in each metals. Odd ratio of stroke patients had 0.96 (Ni)-2.68 (Co) compared to non-stroke cases. This result means that Co increase of 1 raises the risk ratio of stroke by 2.86 times. Based on the results, metal concentration in blood seems to affect incidence of stroke.

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Cerebral Postischemic Hyperperfusion in PET and SPECT (PET과 SPECT에서 나타나는 뇌허혈후 과관류)

  • Cho, Ihn-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.343-351
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    • 2001
  • Cerebral post-ischemic hyperperfusion has been observed at the acute and subacute periods of ischemic stroke. In the animal stroke model, early post-ischemic hyperperfusion is the mark of recanalization of the occluded artery with reperfusion. In the PET studios of both humans and experimental animals, early post-ischemic hyperperfusion is not a key factor in the development of tissue infarction and indicates the spontaneous reperfusion of the ischemic brain tissue without late infarction or with small infarction. But late post-ischemic hyperperfusion shows the worse prognosis with reperfusion injury associated with brain tissue necrosis. Early post-ischemic hyperperfusion defined by PET and SPECT may be useful in predicting the prognosis of ischemic stroke and the effect of thrombolytic therapy.

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Neurovascular Mechanisms in Stroke, Neurodegeneration and Recovery

  • Lo, Eng-H.
    • The Korean Journal of Physiology and Pharmacology
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    • v.10 no.5
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    • pp.223-229
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    • 2006
  • The emerging concept of the 'neurovascular unit' may enable a powerful paradigm shift for neuroscience. Instead of a pure focus on the 'neurobiology' of disease, an opportunity now exists to return to a more integrative approach. The neurovascular unit emphasizes that signaling between vascular and neuronal compartments comprise the basis for both function and dysfunction in brain. Hence, brain disorders are not just due to death of neurons, but instead manifested as cell signaling perturbations at the neurovascular interface. In this mini-review, we will examine 3 examples of this hypothesis: neurovascular mechanisms involved in the thrombolytic therapy of stroke, the crosstalk between neurogenesis and angiogenesis, and the link between vascular dysfunction and amyloid pathology in Alzheimer's disease. An understanding of cell-cell and cell-matrix signaling at the neurovascular interface may yield new approaches for targeting CNS disorders.

Effects of Observed Action Gait Training on Spatio-temporal Parameter and Motivation of Rehabilitation in Stroke Patients (뇌졸중환자의 동작관찰 보행훈련이 시·공간적 지표와 재활동기에 미치는 영향)

  • Kang, Kwon-Young
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.3
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    • pp.351-360
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    • 2013
  • PURPOSE: The purpose of this study was to investigate the effects of observed action gait training on stroke patients. METHODS: 22 subjects were randomized into two groups. The observed action gait training performed that watched a video of normal gait before gait training and the general gait training without watching it. The experimental group(n=11) performed observed action gait training and the control group(n=11) performed general gait training. Both group received gait training for 3 times per week during 8 weeks. RESULTS: The experimental group showed significant differences in the cadence, gait velocity, stride, step, single limb support, double limb support, stride length and step length(p<.05). The control group showed significant differences only in the stride(p<.05). CONCLUSION: The observed action gait training affected coordination and weight shift, as well as symmetry of the body. Plasticity of the brain was facilitated by repetitive visual and sensory stimulation. The observed action gait training promoted the normal gait by watching the normal gait pattern. In conclusion, motor learning through the sensory stimulation promotes brain plasticity that could improve motor function, and observed action gait training indirectly identified stimulated brain activities.

A Case of The Stroke Patient with Systemic lupus erythematosus(SLE) (뇌경색이 병발(倂發)한 전신성 홍반성 루푸스 환자 1례(例) 보고)

  • Lim, Seung-Man;Oh, Sang-Deok;Shin, Hyeon-Su;Kim, Yeong-Tae;Ra, Su-Yeon;Paik, Eun-Tan
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.729-733
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    • 2001
  • We report a case of the cerebellar infarction and pons, medulla and mid brain infarction seen in a 30-year-old female with systemic lupus erythematosus(SLE). SLE has been diagnosed at 1992, and treated with western medicine for 10 years. The patient with right hand tremor and dysarthria, as the symptoms of a cerebellar infarction, visited our hospital. During treatment, the patient constantly complained left knee pain, it turned out the bone infarction and ligament injury in the MRI scan at May, 18, 2001, that was the side effect of the long period steroid therapy. At June 1, 2001, the patient revealed quadriparesis, dysphagia and dizziness. So we took the brain MRI scan, it showed pons, medulla and mid brain infarction. As the consequence of the oriental treatments, the symptoms of SLE had the improvement and the values of BUN, Creatinine were improved. But the symptoms of the stroke were not much changed.

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A Study on Pathological Pattern Detection using the quasi-Bisymmetry of MRI DWI Brain Image (MRI 확산강조 뇌영상의 유사대칭성을 이용한 병변검출에 관한 연구)

  • Kim, S.H.;Lee, H.W.;Lee, J.W.;Jeong, W.G.;Gang, Ik-Tae;Lee, G.K.
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.2 no.4
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    • pp.37-44
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    • 2009
  • Stroke patients are the most in the cause of death among Koreans. Therefore, an accurate diagnosis of stroke is very important. But, it is the only way to diagnose strokes that the doctors see the MRI image and detect the pathological pattern. In this paper, we proposed the new method to detect the pathological pattern of a suspected stroke. We used the quasibi-symmetry of the MRI brain image in our new method. we detected pathological pattern applied the proposed method, and show the result.

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