• Title/Summary/Keyword: Cerebral Hemorrhage

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Effect of Physical Therapy on the Motor Function and Mental State Recovery in Stroke Patients (뇌졸중 환자에 있어서 물리치료가 운동기능과 인지기능의 회복에 미치는 영향)

  • Kim, Hee-Han;Kim, Yoo-Sup;Lee, Hye-Jin;Song, Myung-Soo
    • Journal of Korean Physical Therapy Science
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    • v.9 no.4
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    • pp.15-23
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    • 2002
  • In order to find the effects of physical therapy on the recovery of motor functions and mental state, a survey was conducted to 63 patients who, diagnosed as stroke by brain CT, had been hospitalized in a university medical center located in Jeonbuk provincial area from December 2000 to August 2001. The outcomes of the survey are as follows: 1. The subjects of the study were composed of 35 males(55.6%) and 28 females(44.4%), with 34(54.0%) below 60 in age and 29(46.0%) older than 60 years. 2. As to type of lesion, the surveyed patients were divided into 28(44.4%) with cerebral infarction, 24(38.1%) with cerebral hemorrhage, and 11(17.5%) with subarachnoid hemorrhage. In terms of size of lesion, they were divided into 29(46.0% with less than tan 1cm, 15 (23.8%) with $1{\sim}2cm$ and 19(30.2%) with longer than 2cm. Thirty-five patients(55.7%) reported paralysis in their right side, while 28(44.8%) complained paralysis in their left side. No recidivation was reported by 51(81.1%) while recidivation was asserted by 12(19%). Among them, 27(42.9%) had no past history but 36(57.1%) had such. 3. Regarding the time hour onset to admission to physical therapy, 46patients(73.0%) experienced it for less than one month, while 17(27.0%) for longer than one month. In terms of period of physical therapy, 30(47.6%) underwent the therapy for less than one month, 18(28.6%) for 1-2 months and 15(23.8%) for longer than 2 months. As is shown in the above study, the longer the period of physical therapy is, the more changes might occur in points of MMSE-K and MMAS. It may, therefore, be concluded that sufficiently longer period of physical therapy ensures the increased recovery of physical functions from stroke.

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Characteristics of Head Injuries After Skiing and Snowboarding Accident (스키와 스노보드 사고에서 두부손상의 특징)

  • Kang, Sung Chan;Lee, Kang Hyun;Choi, Han Joo;Park, Kyung Hye;Kim, Sang Chul;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.53-58
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    • 2008
  • Purpose: Skiing and snowboarding are becoming increasingly popular. Accordingly, the incidences of injuries among skiers and snowboarders are also increasing. The purpose of this study was to investigate the injury patterns of and the contributing factors to head injuries of skiers and snowboarders and to evaluate the differences in characteristics between skiing and snowboarding head injuries. Methods: One-hundred patients who visited the emergency department of Wonju Christian Hospital between January 2005 and March 2007 due to head injuries from skiing and snowboarding were enrolled. The mechanisms and the histories of the injuries were investigated by surveying the patients, and the degrees of head injuries were estimated by using brain CT and the Glasgow Coma Scale. The degrees and the characteristics of brain injuries were also analyzed and compared between skiers and snowboarders. Results: Out of 100 patients, 39 were injured by skiing, and 61 were injured by snowboarding. The mean age of the skiers was $26.7{\pm}10.0$, and that of the snowboarders was $26.7{\pm}6.2$. The percentage of male skiers was 43.6%, and that of snowboarders was 63.9%. The most frequent initial chief complaints of head-injured skiers and snowboarders were headache and mental change. The most common mechanism of injuries was a slip down. The mean Abbreviated Injury Scale Score (AIS score) of the skier group was $4.5{\pm}2.1$ and that of the snowboarder group was $5.9{\pm}5.0$ (p=0.222). The percentage of helmet users was 7.1% among skiers and 20.8% among snowboarders (p=0.346). Head injuries were composed of cerebral concussion (92.0%) and intracranial hemorrhage (8.0%). Intracranial hemorrhage was most frequently caused by falling down (62.5%). Conclusion: The most common type of head injury to skiers and snowboarders was cerebral concussion, and severe damage was usually caused by jumping and falling down. No differences in the characteristics of the head injuries existed between skiing and snowboarding injuries.

Socioeconomic Differentials in Stroke and Cardiovascular Disease Mortality in Korea (소득계층에 따른 뇌심혈관질환 사망률 차이)

  • Im Jeong-Soo;Choi Dae-Kyung;Yim Jun;Hong Du-Ho;Kim Jong-Kyun;Park Sang-Hyun;Youn Sung-Tae
    • Korean Journal of Health Education and Promotion
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    • v.23 no.2
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    • pp.109-119
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    • 2006
  • Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

Genome Wide Expression Analysis of the Restored Changes by Carthami Flos Extract Treatment on Rat Brain Injury (흰쥐의 손상된 뇌조직에서의 유전자 발현 변화에 대한 홍화(紅花) 추출물 투여의 작용)

  • Kim, Bu-Yeo;Limb, Se-Hyun;Lee, Guem-San;Kim, Hyung-Woo;Lim, Chi-Yeon;Cho, Su-In
    • The Journal of Internal Korean Medicine
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    • v.31 no.4
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    • pp.706-713
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    • 2010
  • Objectives : The source is from the flower of Carthamus tinctorius L., family Compositae. It is used in clinical medicine to promote blood circulation, remove blood stasis, promote menstruation and alleviate pain. In the present study, we investigated the genome wide analysis of Carthami Flos on the intra-cranial hemorrhage(ICH) model. Methods : ICH in rat was induced by injection of collagenase type IV and Carthami Flos extract(CFe) was administered orally. The molecular profile of cerebral hemorrhage in rat brain tissue was measured using microarray technique to identify up- or down- regulated genes in brain tissue. Results : Expression profile showed that diverse genes were up- or down-regulated by ICH induction. Administration of CFe restored the expression level of some of altered genes by ICH to normal expressional level. Interestingly, these recovered genes by CFe were involved in the same biological pathways which were significantly activated or suppressed by ICH. Conclusion : The above results might explain the therapeutic mechanism of CFe on ICH. Further, by analyzing interaction network, core genes was identified which could be key molecular targets of CFe against ICH.

In-Vitro Study of Urokinase Thrombolysis Following Stereotactic Aspiration of Intracerebral Hematoma

  • Son, Wonsoo;Park, Jaechan;Kang, Dong-Hun;Han, Young-Min;Choi, Yeon-Ju;Ohk, Boram
    • Journal of Korean Neurosurgical Society
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    • v.63 no.3
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    • pp.380-385
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    • 2020
  • Objective : A consensus regarding the ideal regimen for urokinase (UK) thrombolysis subsequent to stereotactic spontaneous intracerebral hemorrhage aspiration has yet to be established. The purpose of this study is to evaluate the efficacy of UK thrombolysis relative to when the regimen is changed. Methods : Venous blood from 30 heathy volunteers was obtained for this in-vitro study. Various concentrations of UK solution were added to microcentrifuge tubes containing the clotted blood. The efficacy of UK thrombolysis was identified by checking the weight of lysed hematoma following various time intervals with different concentrations of UK solution. Group one, the "3×4" group involved four administrations every 3 hours over 12 hours, and group two, the "6×2" group involved two administrations every 6 hours over 12 hours. Results : More hematoma was lysed in the 3×4 group than the 6×2 group across all concentration levels (however, the differences were only significant between groups at the 500 and 1000 IU concentration levels, p<0.05). There were no significant differences of lysed hematoma among the various UK solution concentrations within groups. Conclusion : This study suggests that frequent administrations of UK thrombolysis may result in a greater degree of lysed hematoma in comparison to a higher concentration of UK.

Dissecting Aneurysm of Vertebral Artery Manifestating as Contralateral Abducens Nerve Palsy

  • Jeon, Jin Sue;Lee, Sang Hyung;Son, Young-Je;Chung, Young Seob
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.194-196
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    • 2013
  • Isolated abducens nerve paresis related to ruptured vertebral artery (VA) aneurysm is rare. It usually occurs bilaterally or ipsilaterally to the pathologic lesions. We report the case of a contralateral sixth nerve palsy following ruptured dissecting VA aneurysm. A 38-year-old man was admitted for the evaluation of a 6-day history of headache. Abnormalities were not seen on initial computed tomography (CT). On admission, the patient was alert and no signs reflecting neurologic deficits were noted. Time of flight magnetic resonance angiography revealed a fusiform dilatation of the right VA involving origin of the posterior inferior cerebellar artery. The patient suddenly suffered from severe headache with diplopia the day before the scheduled cerebral angiography. Neurologic examination disclosed nuchal rigidity and isolated left abducens nerve palsy. Emergent CT scan showed high density in the basal and prepontine cistern compatible with ruptured aneurismal hemorrhage. Right vertebral angiography illustrated a right VA dissecting aneurysm with prominent displaced vertebrobasilar artery to inferiorly on left side. Double-stent placement was conducted for the treatment of ruptured dissecting VA aneurysm. No diffusion restriction signals were observed in follow-up magnetic resonance imaging of the brain stem. Eleven weeks later, full recovery of left sixth nerve palsy was documented photographically. In conclusion, isolated contralateral abducens nerve palsy associated with ruptured VA aneurysm may develop due to direct nerve compression by displaced verterobasilar artery triggered by primary thick clot in the prepontine cistern.

Acute Spontaneous Subdural Hematoma due to Rupture of a Tiny Cortical Arteriovenous Malformation

  • Choi, Hyuk Jin;Lee, Jae Il;Nam, Kyoung Hyup;Ko, Jun Kyeung
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.547-549
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    • 2015
  • Acute subdural hematoma (SDH) of arterial origin is rare, especially SDH associated with an arteriovenous malformation (AVM) is extremely rare. The authors report a case of acute spontaneous SDH due to rupture of a tiny cortical AVM. A 51-year-old male presented with sudden onset headache and mentality deterioration without a history of trauma. Brain CT revealed a large volume acute SDH compressing the right cerebral hemisphere with subfalcine and tentorial herniation. Emergency decompressive craniectomy was performed to remove the hematoma and during surgery a small (5 mm sized) conglomerated aciniform mass with two surrounding enlarged vessels was identified on the parietal cortex. After warm saline irrigation of the mass, active bleeding developed from a one of the vessel. The bleeding was stopped by coagulation and the vessels were removed. Histopathological examination confirmed the lesion as an AVM. We concluded that a small cortical AVM existed at this area, and that the cortical AVM had caused the acute SDH. Follow up conventional angiography confirmed the absence of remnant AVM or any other vascular abnormality. This report demonstrates rupture of a cortical AVM is worth considering when a patient presents with non-traumatic SDH without intracerebral hemorrhage or subarachnoid hemorrhage.

Associated Brain Parenchymal Abnormalities in Developmental Venous Anomalies: Evaluation with Susceptibility-weighted MR Imaging

  • Ryu, Hyeon Gyu;Choi, Dae Seob;Cho, Soo Bueum;Shin, Hwa Seon;Choi, Ho Cheol;Jeong, Boseul;Seo, Hyemin;Cho, Jae Min
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.3
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    • pp.146-152
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    • 2015
  • Purpose: The purpose of this study was to evaluate the associated brain parenchymal abnormalities of developmental venous anomalies (DVA) with susceptibility-weighted image (SWI). Materials and Methods: Between January 2012 and June 2013, 2356 patients underwent brain MR examinations with contrast enhancement. We retrospectively reviewed their MR examinations and data were collected as per the following criteria: incidence, locations, and associated parenchymal signal abnormalities of DVAs on T2-weighted image, fluid-attenuated inversion recovery (FLAIR), and SWI. Contrast enhanced T1-weighted image was used to diagnose DVA. Results: Of the 2356 patients examined, 57 DVAs were detected in 57 patients (2.4%); 47 (82.4%) were in either lobe of the supratentorial brain, 9 (15.7%) were in the cerebellum, and 1 (1.7%) was in the pons. Of the 57 DVAs identified, 20 (35.1%) had associated parenchymal abnormalities in the drainage area. Among the 20 DVAs which had associated parenchymal abnormalities, 13 showed hemorrhagic foci on SWI, and 7 demonstrated only increased parenchymal signal abnormalities on T2-weighted and FLAIR images. In 5 of the 13 patients (38.5%) who had hemorrhagic foci, the hemorrhagic lesions were demonstrated only on SWI. Conclusion: The overall incidence of DVAs was 2.4%. Parenchymal abnormalities were associated with DVAs in 35.1% of the cases. On SWI, hemorrhage was detected in 22.8% of DVAs. Thus, we conclude that SWI might give a potential for understanding of the pathophysiology of parenchymal abnormalities in DVAs.

Traumatic Brain Injury in a Pomeranian Dog: Clinical, Computed Tomography, and Necropsy Findings (포메라니언 종에서 발생한 외상성 뇌손상 증례보고; 임상적, 전산화 단층촬영, 부검 소견)

  • Lee, Hee-Chun;Choi, Eul-Soo;Cho, Kyu-Woan;Kang, Byeong-Teck;Kim, Ju-Won;Yu, Chi-Ho;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.579-583
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    • 2010
  • An 18-month-old intact male Pomeranian dog was presented because of traumatic head injury from a fall. Based on physical and neurological examination, brain injury was suspected. On plain skull radiographs, bony fragment following fracture was identified in the region of the right occipital bone. On computed tomography (CT) images, there were specific findings associated with an intracranial hemorrhage. The patient expired few hours after diagnosis, and performed necropsy. On gross findings, intracerebral hemorrhage and edema was detected and those were consistent with CT images. This report describes the clinical findings, CT imaging characteristics, necropsy findings, and histopathologic features of severe traumatic brain injury in a dog.

Body Mass Index and Risk of Hemorrhagic Stroke in Korean Adults: Case-control Study (체질량지수와 출혈성 뇌졸중 발생간의 관련성에 대한 환자-대조군연구)

  • Kim, Seon-Ha;Lee, Yong-Seok;Lee, Seung-Mi;Yoon, Byung-Woo;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.313-320
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    • 2007
  • Objectives : To evaluate the association between body mass index (BMI) and hemorrhagic stroke. Methods : A case-control study was conducted on 2,712 persons (904 cases, 904 hospital controls, and 904 community controls) participating in an Acute Brain Bleeding Analysis study from October 2002 to March 2004. Two controls for each case were matched according to age and gender. The information was obtained by trained interviewers using standardized questionnaire. A conditional logistic regression model was used to estimate the association between BMI and the frequency of having a hemorrhagic stroke. Results : Obese men (25.0 $\leq$ BMI < $30.0\;kg/m^2$) had an odds ratios (OR) of 1.39 (95% CI 1.03 to 1.87) a hemorrhagic stroke, compared to men with a normal BMI (18.5 to $24.9\;kg/m^2$). Conversely, women with lower BMI had a higher risk of having hemorrhagic stroke. With respect to subtypes of hemorrahagic stroke, we observed about a three-fold increase in the risk of intracerebral hemorrhage (ICH) in the highly obese group. However, these trends were not significant in patients with subarachnoid hemorrhages. Conclusions : Obesity was identified as one of the risk factors in hemorrhagic stroke, in particular ICH. Conversely, in women, a lean body weight increases the risk of hemorrhagic stroke. Consequently, managing one's weight is essential to reduce the risks of hemorrhagic stroke.