• Title/Summary/Keyword: Cerebral Hemorrhage

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Sensitivity of Rabbit Cerebral Artery to Serotonin is Increased with the Moderate Increase of Extracellular $K^+$

  • Suh, Suk-Hyo;Park, Sung-Jin;Choi, Jai-Young;Sim, Jae-Hoon;Kim, Young-Chul;Kim, Sung-Joon;So, In-Suk;Kim, Ki-Whan
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.6
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    • pp.695-703
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    • 1998
  • $[K^+]_o$ can be increased under a variety of conditions including subarachnoid hemorrhage. The increase of $[K^+]_o$ in the range of $5{\sim}15$ mM may affect tensions of blood vessels and can change their sensitivity to various vasoactive substances. Therefore, it was examined in the present study whether the sensitivity of cerebral arteries to vasoactive substances can be changed with the moderate increase of $[K^+]_o$, using Mulvany-type myograph and $[Ca^{2+}]_c$ measurement. The contractions of basilar artery and branch of middle cerebral artery induced by histamine were not increased with the elevation of $[K^+]_o$ from 6 mM to 9 mM or 12 mM. On the contrary, the contractions induced by serotonin were significantly increased with the elevation of $[K^+]_o$. The contractions were also significantly increased by the treatment with nitro-L-arginine $(10^{-4}$ M for 20 minutes). In the nitro-L-arginine treated arteries, the contractions induced by serotonin were significantly increased with the elevation of $[K^+]_o$ from 6 mM to 12 mM. $K^+-induced$ relaxation was evoked with the stepwise increment of extracellular $K^+$ from 0 or 2 mM to 12 mM by 2 mM in basilar arterial rings, which were contracted by histamine. But $[K^+]_o$ elevation from 4 or 6 mM to 12 mM by the stepwise increment evoked no significant relaxation. Basal tension of basilar artery was increased with $[K^+]_o$ elevation from 6 mM to 12 mM by 2 mM steps or by the treatment with ouabain and the increase of basal tension was blocked by verapamil. The cytosolic free $Ca^{2+}$ level was not increased by the single treatment with serotonin or with the elevation of $[K^+]_o$ from 4 mM to 8 or 12 mM. In contrast to the single treatment, the $Ca^{2+}$ level was increased by the combined treatment with serotonin and the elevation of $[K^+]_o$. The increase of free $Ca^{2+}$ concentration was blocked by the treatment with verapamil. These data suggest that the sensitivity of cerebral artery to serotonin is increased with the moderate increase of $[K^+]_o$ and the increased sensitivity to serotonin is due to the increased $[Ca^{2+}]_i$ induced by extracellular $Ca^{2+}$ influx.

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Clinical Results from Single-Fraction Stereotactic Radiosurgery (SRS) of Brain Arteriovenous Malformation: Single Center Experience (뇌동정맥기형에서 선형가속기를 이용한 방사선 수술 후의 임상적 결과)

  • Lim, Soo-Mee;Lee, Re-Na;Suh, Hyun-Suk
    • Progress in Medical Physics
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    • v.21 no.3
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    • pp.274-280
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    • 2010
  • The purpose of this study was to analyze the effect of single-fraction stereotactic radiosurgery (SRS) for the treatment of 15 cases of cerebral arteriovenous malformations (AVMs). Between 2002 and 2009, of the 25 patients who had SRS for the treatment of cerebral AVM, 15 patients (6 men, 9 women) taken a digital subtraction angiography (DSA) over 12 months after SRS were included. We retrospectively evaluated the size, location, hemorrhage of nidus, angiographic changes on follow-up on the MR angiography and DSA, and clinical complications during follow-up periods. At a median follow-up of 24 months (range 12-89), complete obliteration of nidus was observed in all patients (100%) while residual draining veins was observed in 3 patients (20%). There was no clinical complication during the follow-up period except seizure in 1 patient. The mean nidus volume was 4.7cc (0.5~11.7 cc, SD 3.7 cc). The locations of nidus were in cerebral hemisphere in 11 patients, cerebellum in 2 patients, basal ganglia in 1 patient, and pons in 1 patient respectively. 9 cases were hemorrhagic, and 6 cases were non-hemorrhagic AVMs. The SRS with LINAC is a safe and effective treatment for cerebral AVMs when the follow up period is over 4 years. However, it is recommended to continue to follow up until the draining vein on arterial phase of follow up DSA disappears completely.

Comparison of Stent-Assisted Coil Embolization Versus Coil Embolization Alone for Ruptured Cerebral Aneurysms with Mild Symptoms: A Single-Clinic Experience (경미한 증상을 가지는 파열 뇌동맥류의 치료에 있어서 스텐트를 이용한 코일 색전술과 단순 코일 색전술의 비교: 단일 병원 경험)

  • Gayeong Lim;Shang Hun Shin;Tae Young Lee;Woon-Jung Kwon;Byeong-Su Park;Soon Chan Kwon
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.887-897
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    • 2022
  • Purpose To evaluate the safety and efficacy of stent-assisted coil embolization (SAC) in acutely ruptured cerebral aneurysms without severe symptoms, and thus, the usefulness of the stent itself in patients with subarachnoid hemorrhages. Materials and Methods From January 2017 to June 2019, 118 patients were treated with coil embolization for acutely ruptured cerebral aneurysms without severe symptoms (Hunt & Hess grade ≤ 3). The periprocedural complications, six-month modified Rankin scores (mRS), and six-month radiologic outcomes were compared between 56 patients with SAC and 62 patients without SAC (non-SAC). Results The rate of good clinical outcomes (mRS ≤ 2), as well as the rate of hemorrhagic and ischemic complications, showed no significant difference between the SAC and non-SAC groups. Moreover, compared to the non-SAC group, the SAC group showed a lower recanalization rate on the six-month follow-up angiogram (20% vs. 39.3%, p = 0.001). Conclusion Although stent use was not significantly associated with clinical outcomes in coil embolization of ruptured cerebral aneurysms with non-severe symptoms (Hunt & Hess grade ≤ 3), it significantly decreased the rate of recanalization on follow-up cerebral angiograms.

Analysis of the Entrance Surface Dose (ESD) and Contrast Usage of Trance Femoral Cerebral Angiography (TFCA) and Cerebral Computed Tomographic Angiography (CCTA) for Cerebrovascular Disease Examining (뇌혈관 질환 검사를 위한 뇌혈관 조영술(TFCA)과 뇌혈관 전산화 단층 촬영 검사(CCTA)의 입사표면선량(ESD) 및 조영제 사용량 분석)

  • Seo, Young-Hyun;Hong, Cheon-Gi;Song, Jong-Nam
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.495-502
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    • 2019
  • A typical cerebrovascular disease among cerebrovascular diseases is vascular diseases such as cerebral infarction, cerebral hemorrhage, cerebral aneurysm, cerebrovascular stenosis. If the disease occurs and causes cerebral damage, it may be difficult to recover completely. So that, Must continue to perform health care through examination early. In particular, Because most cerebrovascular disease examining use radiation equipment and Thus this study was to find out how to select about the optimal examining method and X-ray dose decrease method among different examining method though comparison and analysis for the entrance surface dose (ESD) on cerebrovascular examining with Trance Femoral Cerebral angiography (TFCA) and Cerebral Computed Tomographic Angiography (CCTA). Also, want to find out how to select about the optimal examining method for worried patient that contrast medium side effect though measuring and evaluating for contrast usage. Data were collected from 70 patients (43 males and 27 females) who underwent CCTA at Yeosoo region hospital from June 2018 to December 2018 and 61 patients (34 males and 27 females) who underwent TFCA at Pyeongtaek region hospital from June 2018 to November 2018. ESD analysis method collected retrospective data though M-view and PACS PLUS program, Used contrast usage measuring method did reality measuring method. In the analysis using SPSS, the ESD of TFCA was $245.74{\pm}71.91$, which was $32.05{\pm}7.74$ lower than the dose of $277.79{\pm}79.65$ of CCTA ESD, and statistically significant at t = 3.249, p = 0.017 (p<0.05). As a result of the comparison of the total amount of contrast agent, the mean contrast agent used in TFCA was $55.05{\pm}17.68ml$, which was about 14.95 smaller than the amount of contrast agent used in CCTA, and statistically significant t = -4.548, p<0.001. In conclusion, the ESD of TFCA was statistically significantly lower than that of CCTA, and also the used contrast usage was significantly tiny than that of CCTA. Therefore, Select the method to increase the utilization of TFCA for cerebral disease examining, we can consider X-ray dose decrease method at the same time as to decrease side effect of contrast medium.

The Effect of Mobilization With Movements Applied Sacro-Iliac Joint on Gait of Stroke Patient (천장관절에 적용한 움직임을 동반한 관절가동술이 뇌졸중 환자의 보행에 미치는 효과)

  • Lim, Hyoun-Chyoul;Kong, Sun-Woong;Jung, Yeon-Woo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.17 no.1
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    • pp.45-50
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    • 2011
  • Background: To determine effects of mobilization with movements (MWM) application on stroke patient with hypomobility on sacroiliac joint. Methods: The subject was 47years old male who have left hemiplegia because of right intra-cerebral hemorrhage. The subject was have hypomobility on sacroiliac joint. MWM using during 4weeks and using Berg balance scale (BBS), Timed up and go (TUG), 10meter walking (10MW) test for evaluation. Results: The results of this study were summarized below; BBS score for evaluating balance ability was increased, and TUG time, 10MW test time was decrease. Conclusion: We consider that MWM application on stroke patient with hypomobility on sacroiliac joint is not only regain mobility on sacroiliac joint but also increase in balance ability and walking speed.

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Diagnostic Usefulness of High Resolution Cross Sectional MRI in Symptomatic Middle Cerabral Arterial Dissection

  • Lee, Hai-Ong;Kwak, Hyo-Sung;Chung, Gyung-Ho;Hwang, Seung-Bae
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.370-372
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    • 2011
  • Dissection of the middle cerebral artery (MCA) is less frequent compared with dissection of the vertebrobasilar system or carotid artery. Recently, high-resolution cross sectional MR imaging (HRMRI) has emerged as a potential technique for atherosclerotic plaque imaging in MCA, We introduce the findings of HRMRI in a 56-year-old woman with traumatic MCA dissection, HRMRI showed an intimal flap and tapered pseudolumen with intra-luminal hemorrhage, We performed stent deployment about MCA dissection after failed medical treatment Three months later, there was no in-stent restenosis and no further neurological deficit were noted.

Rupture of De Novo Anterior Communicating Artery Aneurysm 8 Days after the Clipping of Ruptured Middle Cerebral Artery Aneurysm

  • Ha, Sung-Kon;Lim, Dong-Jun;Kim, Sang-Dae;Kim, Se-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.236-238
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    • 2013
  • Rapidly developed de novo aneurysm is very rare. We present a rapidly developed and ruptured de novo anterior communicating aneurysm 8 days after the rupture of another aneurysm. This de novo aneurysm was not apparent in the initial 3-dimensional computed tomography and digital subtraction angiography. We reviewed the literature and discussed possible mechanisms for the development of this de novo aneurysm.

Intracerebral Hematoma Caused by Ruptured Traumatic Pseudoaneurysm of the Middle Meningeal Artery : A Case Report

  • Lim, Dong-Ho;Kim, Tae-Sun;Joo, Sung-Pil;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.416-418
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    • 2007
  • Hematomas caused by ruptured traumatic pseudoaneurysms of the middle meningeal artery (MMA) usually present with extradural hematomas, whereas intradural intraparenchymal hematomas are extremely rare. We report a case of traumatic pseudoaneurysm of the MMA giving rise to an intracerebral hematoma after head trauma. A 70-year-old man suffered a massive intracerebral temporoparietal hemorrhage after a head injury. CT angiogram of the brain revealed a large hematoma in the right middle cranial fossa extending to the right sylvian fissure. Cerebral angiogram also revealed a pseudoaneurysm of the MMA, which was successfully treated surgically. Although traumatic MMA pseudoaneurysm producing intracerebral hematoma (ICH) is rare, it should be considered as a possible cause of intracerebral hematoma.

In Situ Intersegmental Anastomosis within a Single Artery for Treatment of an Aneurysm at the Posterior Inferior Cerebellar Artery : Closing Omega Bypass

  • Lee, Sung Ho;Choi, Seok Keun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.467-470
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    • 2015
  • A 74-year-old patient was diagnosed with a subarachnoid hemorrhage suspected from a dissecting aneurysm located at the lateral medullary segment of the posterior inferior cerebellar artery (PICA). Because perforators to the medulla arose both proximal and distal to the dissecting segment, revascularization for distal flow was essential. However, several previously reported methods for anastomosis, such as an occipital artery-PICA bypass or resection with PICA end-to-end anastomosis could not be used. Ultimately, we performed an in situ side-to-side anastomosis of the proximal loop of the PICA with distal caudal loops within a single artery, as a "closing omega," followed by trapping of the dissected segment. The aneurysm was obliterated successfully, with intact patency of the revascularized PICA.

The Dissecting Aneurysm of the Posterior Inferior Cerebellar Artery with Unusual Clinical Course

  • Lee, Hyoung-Soo;Lee, Sang-Youl;Rhee, Woo-Tack;Jang, Yeon-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.369-372
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    • 2006
  • The dissecting aneurysms of the posterior cerebral circulation arise most commonly from the vertebral artery and occasionally extend to the posterior inferior cerebellar artery[PICA]. The dissecting aneurysm localized in the PICA without involving the vertebral artery is rare. We present a PICA dissecting aneurysm that had kaleidoscopic clinical course of bleeding, occlusion, and recanalization before the surgery. The patient had serial follow-up angiograms based on significant changes of clinical status. The patient successfully underwent microsurgical trapping with clips for the dissecting aneurysm and showed neurological improvement.