• The Korea Journal of Herbology
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• v.26 no.4
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• pp.169-180
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• 2011

Objectives : This study aimed at evaluation of the effects of Rhodiola rosea on brain edema and expressions of matrix metalloproteinases (MMPs) related to blood-brain barrier (BBB) disruption. Methods : Brain edema following intracerebral hemorrhage (ICH) was induced by the stereotaxic intrastriatal injection of bacterial collagenase type VII in rats (Sprague-Dawley). Then ethanol extract of Rhodiola rosea was treated once a day for 3 days. Brain edema % and water contents, and BBB leakage were examined. Immunohistochemistry was processed for MMP-9, MMP-12, and iNOS expressions in the brain sections and each immuno-labeled cells were analyzed with image analysis software. Results : 1. Ethanol extract of Rhodiola rosea reduced brain edema following ICH in rats significantly. 2. Ethanol extract of Rhodiola rosea reduced excessive brain tissue water contents following ICH in rats significantly. 3. Ethanol extract of Rhodiola rosea reduced BBB leakage in the cerebral cortex following ICH in rats. 4. Ethanol extract of Rhodiola rosea reduced cellular edema of neurons in peri-hematoma and the cerebral cortex following ICH in rats significantly. 5. Ethanol extract of Rhodiola rosea reduced MMP-9 positive cells in the cerebral cortex following ICH in rats significantly. 6. Ethanol extract of Rhodiola rosea reduced MMP-12 positive vessels in the cerebral cortex following ICH in rats significantly. 7. Ethanol extract of Rhodiola rosea reduced iNOS positive cells in the cerebral cortex and external capsule following ICH in rats significantly. Conclusions : These results suggest that Rhodiola rosea reveals protective effect against brain edema and cytotoxic edema of neurons by means of down-regulation of MMPs and iNOS expressions, and inhibition of BBB leakage.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.681-689
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• 2023

Objective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.995-1000
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• 2000

Objective : The authors reviewed 280 cases with intracranial arteriovenous malformations(AVMs) to identify risk factors of hemorrhage. Patients and Methods : From 1983 to 1997, a total 280 patients with AVMs were treated. Among them, 64% had a history of hemorrhage. Angiograms were retrospectively analyzed with particular attention to the size of the AVM, venous drainage, the location of the AVM and presence of associated aneurysm or varix. These characteristics were statistically analysed in relation to occurrence of hemorrhage. Results : A single variate analysis demonstrated that small size(p=0.0003), deep venous drainage(p=0.025) and periventricular location(p<0.0001) had a strong positive correlation. Associated aneurysms and varices were not found as hemorrhagic risk factors. A multivariate analysis revealed that the size of the AVM was most significant hemorrhagic factor(p=0.0003) followed by deep venous drainage(p=0.025). AVMs with small size and deep venous drainage bled more frequently regardless of their locations. Conclusion : These data would be useful in identifying patients at higher risk for developing hemorrhage of intracranial AVMs.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.89-93
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• 2017

Infratentorial cerebral hemorrhage due to a direct carotid-cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.199-205
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• 2022

Developmental venous anomalies (DVAs) are common intracranial vascular malformations and they are generally do not cause clinical complications. In cases showing DVA and hemorrhage, the hemorrhage is usually associated with adjacent cavernous malformations. Very few cases of intracerebral hemorrhage (ICH) caused by thrombosis in DVA have been reported in the literature. In this case report, we present an interesting case of a large ICH caused by thrombosis within a DVA with an unusual structure that may have potentiated the thrombosis.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.31-44
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• 1998

This observation was made on 163 cases of CVA that were confirmed through survey. They were treated in the Bulgyo Oriental Hospital in Taegu from February to March 1998. The results was as follows, 1. The ration of male to female was 1:1:36 in whole groups. 2. Onset time was occurred $37.4\%$ at 06:00-12:00. $20.0\%$, 00:00-16:00. 3. Of 157 cases of cerebrovascular accidents cerebral infarction (included cerebral thrombosis & cerebral embolism) was presented in $47.4\%$, cerebral hemorrhage in $38.2\%$, subarachnoid hemorrhage in $5.1\%$, and others in $8.9\%$. 4. The most ordinary preceding disease was hypertension. 5. The family history was appeared as $12.9\%$ of the mother, $9.7\%$ of the father.(This observation was made on 155 cases) 6. The body weight of CAV patients was appeared $37.4\%$ in 51-60kg, $30.7\%$ in 61-70kg, $17.8\%$ in below 50kg, and $9.8\%$ in 71-80kg, $4.3\%$ in above 80kg. 7. Of 161 cases, $46.6\%$ did not exercise. 8. Of 163 cases, $65.6\%$ of them did not drink alcohol. 9. Of 162 cases, $63\%$ did not smoke cigarettes. 10. The food taste (food habit) of stroke patients was that they comprised a fancy as $38.0\%$ of salty food, $33.8\%$ of fresh food, and $24.7\%$ of hot food, $3.5\%$ of sweet food.(This observation was made on 143 cases) According to the above result, We must restrain salty food and control positively hypertension and in terms of CVA prevention.

• Journal of Korea Multimedia Society
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• v.20 no.12
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• pp.1980-1991
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• 2017

Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body function in paretic and non-paretic regions. In this study, the impedance parameters were acquired to assess the physical status in the upper extremity of thirty six stroke patients with hemiplegia caused by cerebral hemorrhage (10 patients) and cerebral infarction (26 patients), using bioelectrical impedance. Prediction marker (PM), phase angle (PA), PM/PA, and resistance (R) versus reactance ($X_c$) were utilized to evaluate the functional status of the paretic and non-paretic regions. In addition, the hand grip strength (HGS) and the pinch strength (lateral, palmer, tip) were measured on the upper extremity of hemiplegic stroke patients. PM was distributed in inversely proportional to HGS, but PA was distributed in proportional to HGS. However, there were a number of patients with HGS of 0, regardless of the impedance parameters (PM, PA, R vs. $X_c$). Paretic and non-paretic status in upper extremity of these patients could not be analyzed using impedance parameters. At the rehabilitation therapist's instructions, they were unable to move the hand and fingers of the paretic upper extremity by cranial nerve damage, motor nerve damage, and severe cognitive decline.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.325-333
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• 2001

Objective : To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods : A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups : deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results : The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0%-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion : Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.

• The Korean Journal of Nuclear Medicine
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• v.32 no.5
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• pp.397-402
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• 1998

Purpose: The purpose of this study was to evaluate the phenomenon of diaschisis in the cerebellum and cerebral cortex in patients with pure basal ganglia hemorrhage using cerebral blood flow SPECT. Materials and Methods: Twelve patients with pure basal ganglia hemorrhage were studied with Tc-99m ECD brain SPECT. Asymmetric index (AI) was calculated in the cerebellum and cerebral cortical regions as |$C_R-C_L$/$(C_R-C_L){\times}200$, where $C_R$and $C_L$ are the mean reconstructed counts for the right and left ROIs, respectively. Hypoperfusion was considered to be present when AI was greater than mean +2 SD of 20 control subjects. Results: Mean AI of the cerebellum and cerebral cortical regions in patients with pure basal ganglia hemorrhage was significantly higher than normal controls (p<0.05): Cerebellum ($18.68{\pm}8.94$ vs $4.35{\pm}0.94$, $mean{\pm}SD$), thalamus ($31.91{\pm}10.61$ vs $2.57{\pm}1.45$), basal ganglia ($35.94{\pm}16.15$ vs $4.34{\pm}2.08$), parietal ($18.94{\pm}10.69$ vs $3.24{\pm}0.87$), frontal ($13.60{\pm}10.5$ vs $4.02{\pm}2.04$) and temporal cortex ($15.92{\pm}11.95$ vs $5.13{\pm}1.69$). Ten of the 12 patients had significant hypoperfusion in the contralateral cerebellum. Hypoperfusion was also shown in the ipsilateral thalamus (n=12), ipsilateral parietal (n=12), frontal (n=6) and temporal cortex (n=10). Conclusion: Crossed cerebellar diaschisis (CCD) and cortical diaschisis may frequently occur in patients with pure basal ganglia hemorrhage, suggesting that CCD can develop without the interruption of corticopontocerebellar pathway.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.357-359
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• 2010

While a delayed intracerebral hemorrhage at the site of a ventricular catheter has occasionally been reported in literature, a delayed hemorrhage caused by venous infarction secondary to ventriculoperitoneal shunting has not been previously reported. In the present case, a 68-year-old woman underwent ventriculoperitoneal shunting through a frontal burr hole, and developed a hemorrhagic transformation of venous infarction on the second postoperative day. This massive venous infarction was caused by bipolar coagulation and occlusion of a large paramedian cortical vein in association with atresia of the rostral superior sagittal sinus. Thus, to eliminate the risk of postoperative venous infarction, technical precautions to avoid damaging surface vessels in a burr hole are required under loupe magnification in ventriculoperitoneal shunting.