• Title/Summary/Keyword: Brain edema

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Experience of Meningovascular Syphilis in Human Immunodeficiency Virus Infected Patient

  • Lee, Jung-Pyo;Koo, Sun-Ho;Jin, So-Young;Kim, Tae-Hyong
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.413-416
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    • 2009
  • Since the start of the antibiotic era, syphilis has become rare. However, in recent times, it has tended to be prevalent concomitantly with human immunodeficiency virus (HIV) infection and coinfection in North America and Europe. Now, such cases are expected to increase in elsewhere including Korea. A 40-year-old male patient visited hospital complaining of a headache for about one month. Brain computed tomography and magnetic resonance imaging, showed leptomeninged enhancing mass with edema an right porisylvian region, which was suspected to be glioma. Patient underwent a blood test and was diagnosed with syphilis and acquired immune deficiency syndrome. Partial cortical and subcortical resection were performed after small craniotomy. The dura was thick, adhered to the brain cortex, and was accompanied by hyperemic change of the cortex. The pathologic diagnosis was meningovascular syphilis (MS) in HIV infection. After the operation, the patient was treated with aqueous penicillin G. Thereafter, he had no neurological deficit except intermittent headache. At first, this case was suspected to be glioma, but it was eventually diagnosed as MS in HIV coinfection. At this point the case was judged to be worth reporting.

A Case of Lumbar Metastasis of Choriocarcinoma Masquerading as an Extraosseous Extension of Vertebral Hemangioma

  • Lee, Ji-Hoon;Park, Chan-Woo;Chung, Dong-Hae;Kim, Woo-Kyung
    • Journal of Korean Neurosurgical Society
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    • v.47 no.2
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    • pp.143-147
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    • 2010
  • We report here on an uncommon case of metastatic choriocarcinoma to the lung, brain and lumbar spine. A 33-year-old woman was admitted to the pulmonary department with headache, dyspnea and hemoptysis. There was a history of cesarean section due to intrauterine fetal death at 37-weeks gestation and this occurred 2 weeks before admission to the pulmonary department. The radiological studies revealed a nodular lung mass with hypervascularity in the left upper lobe and also a brain parenchymal lesion in the parietal lobe with marginal bleeding and surrounding edema. She underwent embolization for the lung lesion, which was suspected to be an arteriovenous malformation according to the pulmonary arteriogram. Approximately 10 days after discharge from the pulmonary department, she was readmitted due to back pain and progressive paraparesis. The neuroradiological studies revealed a hypervascular tumor occupying the entire L3 vertebral body and pedicle, and the tumor extended to the epidural area. She underwent embolization of the hypervascular lesion of the lumbar spine, and after which injection of polymethylmethacrylate in the L3 vertebral body, total laminectomy of L3, subtotal removal of the epidural mass and screw fixation of L2 and L4 were performed. The result of biopsy was a choriocarcinoma.

A Case of Infantile Meningioangiomatosis with a Separate Cyst

  • Kim, Seong-Ho;Yoon, Soo-Han;Kim, Jang-Hee
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.252-256
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    • 2009
  • Meningioangiomatosis (MA) is a rare congenital tumor that occurs mostly in 5-15 year old children. There have been only 5 cases previously reported that described the cystic nature within these tumors. We present a case of a MA accompanied by a separate macrocyst. A normally developed 2 year-old female patient presented with partial and generalized seizures. The brain computerized tomogram and magnetic resonance imaging revealed the presence of a calcified mass accompanied by a cyst in the right parietal area, surrounded by low density and high attenuation edema and hemorrhage. Upon right parietal craniotomy, a $1.6cm{\times}1.2cm{\times}0.5cm$ sized plate-like, gray-white, slightly hard mass was seen and it was completely excised. Approximately 1 cm from the mass in the anterior lateral direction, a cyst was found and subsequent biopsy of the cyst wall revealed no tumor tissue, and therefore the cyst was not removed. Pathologic report demonstrated the meningioangiomatosis. Follow up examination 2 years later showed no recurrence of the tumor, and there was no evidence of neurological deficits. Authors suggest that cysts that arise in the surrounding tissues of tumors may not be tumor cysts, and do not require surgical removal.

Thoracic Trauma: Analysis of 150 Cases (흉부손상 150례에 대한 임상적 관찰)

  • 김형묵;김인수
    • Journal of Chest Surgery
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    • v.5 no.2
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    • pp.113-124
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    • 1972
  • Clinical observations were performed on 150 cases of chest trauma, those were admitted and treated at the Department of Surgery, Korea University Woosok Hospital, during the past 8 years period from August 1965 to August 1972. 1. The ratio of male to female patient of chest trauma was 3.4:1 in male predominence and age from 20 to 50 occupied 62% of the total cases. 2. The most common cause of chest trauma was traffic accident in this series. Eighty-one cases[54%] were injured by traffic accident and total cases due to blunt trauma [non-penetrating injury] were 113 cases[75.4%]including the cases with traffic accident, and remaining 37 cases[24.6%] were due to penetrating injury including 25[16.6%] cases of stab wounds. 3. Hemopneumothorax were observed in 645/[96 cases] of the total cases, and etiologic distribution revealed 78.1% due to non-penetrating trauma and 20.8% due to penetrating injury. 4. Rib fracture was found in 50% of cases. Common injuries associated with rib fracture were lung, brain and liver. 5. Most common symptom was chest pain and respiratory difficulty, and common sign associated with chest injury was decreased respiratory sound and subcutaneous emphysema. 6. Conservative non-operative treatment was performed in 94 cases[62.6%] and 56 cases [37.4%] were treated with operative treatment including 31 cases[20.6%] with open thoracotomy. 7. Overall mortality was 9.3%[14 cases] and most common causes of death were due to brain edema,asphyxia and shock.

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Visual recovery demonstrated by functional MRI and diffusion tensor tractography in bilateral occipital lobe infarction

  • Seo, Jeong Pyo;Jang, Sung Ho
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.152-156
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    • 2014
  • We report on a patient who showed visual recovery following bilateral occipital lobe infarct, as evaluated by follow up functional magnetic resonance imaging (fMRI) and diffusion tensor tractography (DTT). A 56-year-old female patient exhibited severe visual impairment since onset of the cerebral infarct in the bilateral occipital lobes. The patient complained that she could not see anything, although the central part of the visual field remained dimly at 1 week after onset. However, her visual function has shown improvement with time. As a result, at 5 weeks after onset, she notified that her visual field and visual acuity had improved. fMRI and DTT were acquired at 1 week and 4 weeks after onset, using a 1.5-T Philips Gyroscan Intera. The fiber number of left optic radiation (OR) increased from 257 (1-week) to 353 (4-week), although the fiber numbers for right OR were similar. No activation in the occipital lobe was observed on 1-week fMRI. By contrast, activation of the visual cortex, including the bilateral primary visual cortex, was observed on 4-week fMRI. We demonstrated visual recovery in this patient in terms of the changes observed on DTT and fMRI. It appears that the recovery of the left OR was attributed more to resolution of local factors, such as peri-infarct edema, than brain plasticity.

Ethmoidal Meningoencephalocele Associated with Seizure in a Juvenile Alaskan Malamute

  • Park, Sun-young;Lee, Young-jae;Song, Jin-young;Jeon, Seok-ho;Jeong, Ji-yoon;Kang, Byeong-taek;Kang, Ji-hoon;Chang, Jin-hwa;Chang, Dong-woo
    • Journal of Veterinary Clinics
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    • v.33 no.3
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    • pp.168-171
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    • 2016
  • Signalment: An 8-month-old female Alaskan malamute was presented for progressive cluster seizure disorder. Results: There were no abnormalities on neurological examination, survey radiographs, or blood analysis. Magnetic resonance (MR) imaging and computed tomography revealed extension of the olfactory bulb and frontal lobe into the nasal cavity. They also confirmed abnormal anatomy of the nasal turbinates within the rostral part of the nasal cavity and the absence of a cribriform plate. On T2-weighted and fluid-attenuated inversion recovery images, the herniated brain showed heterogeneous and hyperintense signals consistent with intraparenchymal edema. Transverse MR images showed brain herniation into the right frontal cavity and an asymmetrical lateral ventricle because of a left midline shift. On contrast-enhanced MR images, the protruding brain parenchyma was mildly enhanced. Ethmoidal encephalocele was suspected as the final diagnosis. Despite symptomatic treatment, the dog continued to exhibit seizures and was euthanized. Clinical relevance: Ethmoidal encephalocele is a rare disease in dogs. However, it could be considered as a cause of seizure in young dogs.

Fuzzy-based Segmentation Algorithm for Brain Images (퍼지기반의 두뇌영상 영역분할 알고리듬)

  • Lee, Hyo-Jong
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.46 no.12
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    • pp.102-107
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    • 2009
  • As technology gets developed, medical equipments are also modernized and leading-edge systems, such as PACS become popular. Many scientists noticed importance of medical image processing technology. Technique of region segmentation is the first step of digital medical image processing. Segmentation technique helps doctors to find out abnormal symptoms early, such as tumors, edema, and necrotic tissue, and helps to diagnoses correctly. Segmentation of white matter, gray matter and CSF of a brain image is very crucial part. However, the segmentation is not easy due to ambiguous boundaries and inhomogeneous physical characteristics. The rate of incorrect segmentation is high because of these difficulties. Fuzzy-based segmentation algorithms are robust to even ambiguous boundaries. In this paper a modified Fuzzy-based segmentation algorithm is proposed to handle the noise of MR scanners. A proposed algorithm requires minimal computations of mean and variance of neighbor pixels to adjust a new neighbor list. With the addition of minimal compuation, the modified FCM(mFCM) lowers the rate of incorrect clustering below 30% approximately compared the traditional FCM.

Neuroprotective effects of Korean White ginseng and Red ginseng in an ischemic stroke mouse model

  • Jin, Myungho;Kim, Kyung-Min;Lim, Chiyeon;Cho, Suin;Kim, Young Kyun
    • Journal of Ginseng Research
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    • v.46 no.2
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    • pp.275-282
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    • 2022
  • Background: Stroke is a neurological disorder characterized by brain tissue damage following a decrease in oxygen supply to brain due to blocked blood vessels. Reportedly, 80% of all stroke cases are classified as cerebral infarction, and the incidence rate of this condition increases with age. Herein, we compared the efficacies of Korean White ginseng (WG) and Korean Red Ginseng (RG) extracts (WGex and RGex, respectively) in an ischemic stroke mouse model and confirmed the underlying mechanisms of action. Methods: Mice were orally administered WGex or RGex 1 h before middle cerebral artery occlusion (MCAO), for 2 h; the size of the infarct area was measured 24 h after MCAO induction. Then, the neurological deficit score was evaluated and the efficacies of the two extracts were compared. Finally, their mechanisms of action were confirmed with tissue staining and protein quantification. Results: In the MCAO-induced ischemic stroke mouse model, WGex and RGex showed neuroprotective effects in the cortical region, with RGex demonstrating superior efficacy than WGex. Ginsenoside Rg1, a representative indicator substance, was not involved in mediating the effects of WGex and RGex. Conclusion: WGex and RGex could alleviate the brain injury caused by ischemia/reperfusion, with RGex showing a more potent effect. At 1,000 mg/kg body weight, only RGex reduced cerebral infarction and edema, and both anti-inflammatory and anti-apoptotic pathways were involved in mediating these effects.

The Effect of Dodamtang(DDT) on Brain damage and Hypertension (도담탕(導痰湯)이 뇌손상(腦損傷) 및 고혈압(高血壓)에 미치는 영향(影響))

  • Lim, Seong-Min;An, Joung-Jo;Choi, Young;Kim, Yong-Jin;Yoo, Ho-Ryoung;Park, Yang-Chun;Seol, In-Chan;Hwang, Chi-Won;Cho, Hyun-Kyung
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.503-512
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    • 2001
  • Objective : This study was carried out to investigate the effects of DDT on the brain damage and hypertension. Methods : We observed the effect of Dodamtang(DDT) extract on KCN-induced coma, focal brain ischemia by MCA occlusion, cytotoxicity and protection of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35). To prove the effect of DDT as a blood pressure depressant, we measured aldosterone, renin activity, catecholamine, sodium and NO density using the seperated blood plasma. Results : DDT showed a protective effect on cytotoxicity of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35) in a dose dependent manner and proved the significant abridgement of brain ischemic area and edema induced by MCA occlusion, a critical decrease of neurologic deficitic grade in the fore-limbs. DDT didn't reduce the duration of KCN(1.87mg/kg iv.)-induced coma and prolonged the survival rate in the case of KCN(3.0mg/kg iv.)-induced coma by the ratio of 20%. While DDT increased the value of NO in SHR, it significantly decreased the blood pressure of SHR and the value of aldosterone& epinephrine in SHR. Conclusions : These results suggested that DDT might be usefully applied for treatment of hypertension, cerebral infarction, and brain damage.

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Surgical Experience of Infratentorial Meningiomas : Clinical Series at a Single Institution during the 20-Year Period

  • Jung, Min-Ho;Moon, Kyung-Sub;Lee, Kyung-Hwa;Jang, Woo-Youl;Jung, Tae-Young;Jung, Shin
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.321-330
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    • 2014
  • Objective : Based on surgical outcomes of patients with infratentorial meningiomas surgically treated at our institution, we analyzed the predictors for surgical resection, recurrence, complication, and survival. Methods : Of surgically treated 782 patients with intracranial meningioma, 158 (20.2%) consecutive cases of infratentorial location operated on between April 1993 and May 2013 at out institute were reviewed retrospectively. The patients had a median age of 57.1 years (range, 16-77 years), a female predominance of 79.7%, and a mean follow-up duration of 48.4 months (range, 0.8-242.2 months). Results : Gross total resection (Simpson's grade I & II) was achieved in 81.6% (129/158) of patients. Non-skull base location was an independent factor for complete resection. The recurrence rate was 13.3% (21/158) and the 5-, 10-, and 15-year recurrence rates were 8.2%, 12.0%, and 13.3%, respectively. Benign pathology, postoperative KPS over than 90, low peritumoral edema, and complete resection were significantly associated with longer recurrence-free survival rate. The 5-, 10-, and 15-year survival rates were 96.2%, 94.9%, and 94.9%, respectively. Benign pathology, postoperative KPS over than 90 and complete resection were significantly associated with a longer survival rate. The permanent complication rate was 13% (21/158). Skull base location and postoperative KPS less than 90 were independent factors for the occurrence of permanent complication. Conclusion : Our experience shows that infratentorial meningiomas represent a continuing challenge for contemporary neurosurgeons. Various factors are related with resection degree, complications, recurrence and survival.