• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.204-207
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• 2015

We are reporting an unusual case of dural arteriovenous fistula (AVF) of the superior sagittal sinus (SSS) after tamoxifen treatment for breast cancer. A 30-year-old female arrived at the emergency room with a sudden headache and left sided weakness and sensory loss. In her past medical history, she was diagnosed with breast cancer 1 year prior, and subsequently underwent a breast conserving mastectomy with whole breast radiation and adjuvant chemotherapy with tamoxifen. At the time of admission, computed tomography showed a small acute intracerebral hemorrhage at the right parietal cortex, and magnetic resonance imaging showed that a dural AVF at the SSS with a prominent and tortuous venous enhancement along the centrum semiovale was present. Cerebral angiography showed that the dural AVF at the mid-portion of the SSS with meningeal arterial feeding vessels entering the wall of the SSS, then draining through the dilated cortical veins. Our patient had no signs of active malignancy or any abnormalities in her coagulation profile, so it can be concluded that the tamoxifen was the likely cause of the SSS thrombosis and dural AVF. The dural AVF was treated by an endovascular coil embolization for the arterialized segment of the SSS. The patient dramatically recovered favorably from left side motor and sensory deficit. The best clinical approach is to screen potential patients of tamoxifen hormonal therapy and educate them on the sign and symptoms of life threatening thromboembolic events while taking tamoxifen.

• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.222-226
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• 2012

The waffle-cone technique is a modified stent application technique, which involves protrusion of the distal portion of a stent into an aneurysm fundus to provide neck support for subsequent coiling. The authors report two cases of wide necked basilar bifurcation aneurysms, which were not amenable to stent assisted coiling, that were treated using the waffle-cone technique with a Solitaire AB stent. A 58-year-old woman presented with severe headache. Brain CT showed subarachnoid hemorrhage and angiography demonstrated a ruptured giant basilar bifurcation aneurysm with broad neck, which was treated with a Solitaire AB stent and coils using the waffle-cone technique. The second case involved an 81-year-old man, who presented with dizziness caused by brain stem infarction. Angiography also demonstrated a large basilar bifurcation unruptured aneurysm with broad neck. Solitaire AB stent deployment using the waffle-cone technique, followed by coiling resulted in near complete obliteration of aneurysm. The waffle-cone technique with a Solitaire AB stent can be a useful alternative to conventional stent application when it is difficult to catheterize bilateral posterior cerebral arteries in patients with a wide-necked basilar bifurcation aneurysm.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.80-83
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• 2004

The aortic coarctation is located in the distal thoracic aorta or abdominal aorta, or both and is often called ‘middle aortic syndrome’ or ‘mid-aortic dyspastic syndrome’. Etiology is controversial and most cases are seen in young female women. Severe complication such as cardiac or renal dysfunction as well as cerebral hemorrhage may occur, so aggressive surgical intervention may take effect. Lately we experienced a middle aortic syndrome which was not typical because of the patient's advanced age at the time of clinical presentation. The Axillo-femoral artery bypass graft with 6 mm PTFE vascular graft was done.

• Journal of Haehwa Medicine
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• v.14 no.1
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• pp.155-165
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• 2005

I have come to conclusion as follows about Bangpungtongsungsan after literatural study. 1. Bangpungtongsungsan is the medical treatment of heat, wind and dryness. 2. Bangpungtongsungsan is used in head-wind, dizziness, both eye disease, tinnitus, both ear deafness, nasal polyp, uriticaria, sajuabi, beard and hair falling, apoplexy, paralysis of hands and feet, dull mentality, tetanus, epidemic disease characterized by swelling and redness of face, carbuncle, daepungchang, pustule, syphilis, tinea capitis and so on. 3. Bangpungtongsungsan is used in the disease of cerebral hemorrhage, hypertension, arteriosclerosis, constipation, rosacea, hemorrhoids, cutaneous disease, empyema, eye disease, diabetes, asthma, obesity, beriberi, erysipelas, baldhead, fatty heart, chronic nephritis and so on. 4. Bangpungtongsungsan fits in Taeumin who has much wetness-heat and those who have much heat or have much heat but don't give off well. And it doesn't fit in the disease of intolerance to cold and fever in the form of weakness headache, asthenia of the spleen and stomach, cold by internal disorder and so on.

• Journal of Chest Surgery
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• v.45 no.5
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• pp.326-329
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• 2012

Pulmonary arteriovenous malformation (PAVM) is a rare anomalous direct communication between the pulmonary artery and vein with a considerable risk of serious complications such as cerebral thromboembolism or abscess and pulmonary hemorrhage. Although the past, surgical resection such as lobectomy was mostly used to treat PAVM, the recent development of endovascular treatment has made it a primary consideration to perform transcatheter embolization using coils or detachable balloons. We report a case of successful transcatheter embolization of giant PAVM with the second generation Amplatzer vascular plug II as a new self-expanding device.

• The Journal of Korean Physical Therapy
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• v.34 no.6
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• pp.326-331
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• 2022

Purpose: The stroke patients have gait dysfunction due to impaired neural tracts; corticospinal tract (CST), corticoreticular pathway (CRP), and vestibulospinal tract (VST). In this study, we investigated characteristics of gait pattern according to the injury aspect of the neural track in a stroke patient. Methods: One patient and six control subjects of similar age participated. A 19-year-old male patient with spontaneous intracerebral hemorrhage on right basal ganglia, thalamus, corona radiata and cerebral cortex due to arteriovenous malformation rupture. Diffusion tensor imaging (DTI) data was acquired 21 months after the stroke. Kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 21 months DTI, the CST and CRP in affected hemisphere showed severe injury, in contrast, the VST in affected hemisphere showed intact integrity. Result of gait analysis, walking distance and speed were significantly decreased in a patient. The stance rate of unaffected lower limb, the swing rate of affected lower limb and the duration of double stance significantly increased compared with normal control. The knee and hip joint angle were significantly decreased in a patient. Conclusion: We found recovered independent gait ability may be associated with unimpaired VST in a patient with severe injury in CST and CRP.

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1067-1071
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• 2007

Purpose : The aim of this study was to determine whether improved survival of extremely low birth weight infants (ELBWI) was associated with decreased neurodevelopmental disability later in life, and also to identify the factors influencing this disability. Methods : ELBWI admitted to the neonatal intensive care unit of Samsung Medical Center, survived, and followed up until the corrected age of 18 months were enrolled. They were divided into two groups according to admission time: period I (1994-1999, n=36) and period II (2000-2004, n=98). Clinical data were collected retrospectively from the medical records. Results : Survival rates increased from 60.0% to 74.7%, cerebral palsy rates decreased from 22.2% to 8.2% and catch-up growth rate increased from 25.0% to 51.0% during period I and II. Despite less gestational age and birth weight, ELBWI during period II had less periventricular leukomalacia (PVL), sepsis and bronchopulmonary dysplasia compared to period I. The highest risk factors for cerebral palsy were intraventricular hemorrhage (IVH) (${\geq}$Grade III), failure of catch-up growth and PVL. Conclusion : In summary, improved viability was associated with decreased neurodevelopmental disability in ELBWI. Improved neonatal care with resultant decrease in PVL and IVH, and better nutritional support seem to be primarily responsible for this improved outcome.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.501-505
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• 1997

It was reported that use of aprotinin in elderly patients undergoing hypothermic circulatory arrest was associated with an increased risk of renal dysfunction, and myocardial infarction as a result of intravascular coagulation. We reviewed 20 patients who received high-dose aprotinin under deep hypothermic circulatory arrest with(NP group, n= 11) or without selective cerebral perfusion(SP group, n=9). The activated clotting time was exceeded 750 seconds in all but 1 patient. After opening aortic arch, retrograde low flow perfusion was maintained through femoral artery to prevent air embolization to the visceral arteries. Four patients among 20 died during hospitalization'due to bleeding, coronary artery dissection pulmonary hemorrhage and multiple cerebral infarction. Postoperatively, cerebrovascular accidents occurred in two patients; one with preoperative carotid artery dissection and the other with unknown multiple cerebral infarction. In conclusion, use of aprotinin in young patients undergoing hypothermic circulatory arrest did not increase the risk of renal dysfunction or intravascular coagulation if ACT during circulatory arrest is maintained to exceed 750 seconds with low-flow perfusion.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.228-233
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• 2008

Objective : The standard treatment strategy of intracranial aneurysms includes either endovascular coiling or microsurgical clipping. In certain situations such as in giant or dissecting aneurysms, bypass surgery followed by proximal occlusion or trapping of parent artery is required. Methods : The authors assessed the result of extracranial-intracranial (EC-IC) bypass surgery in the treatment of complex intracranial aneurysms in one institute between 2003 and 2007 retrospectively to propose its role as treatment modality. The outcomes of 15 patients with complex aneurysms treated during the last 5 years were reviewed. Six male and 9 female patients, aged 14 to 76 years, presented with symptoms related to hemorrhage in 6 cases, transient ischemic attack (TIA) in 2 un ruptured cases, and permanent infarction in one, and compressive symptoms in 3 cases. Aneurysms were mainly in the internal carotid artery (ICA) in 11 cases, middle cerebral artery (MCA) in 2, posterior cerebral artery (PCA) in one and posterior inferior cerebellar artery (PICA) in one case. Results : The types of aneurysms were 8 cases of large to giant size aneurysms, 5 cases of ICA blood blister-like aneurysms, one dissecting aneurysm, and one pseudoaneurysm related to trauma. High-flow bypass surgery was done in 6 cases with radial artery graft (RAG) in five and saphenous vein graft (SVG) in one. Low-flow bypass was done in nine cases using superficial temporal artery (STA) in eight and occipital artery (OA) in one case. Parent artery occlusion was performed with clipping in 9 patients, with coiling in 4, and with balloon plus coil in 1. Direct aneurysm clip was done in one case. The follow up period ranged from 2 to 48 months (mean 15.0 months). There was no mortality case. The long-term clinical outcome measured by Glasgow outcome scale (GOS) showed good or excellent outcome in 13/15. The overall surgery related morbidity was 20% (3/15) including 2 emergency bypass surgeries due to unexpected parent artery occlusion during direct clipping procedure. The short-term postoperative bypass graft patency rates were 100% but the long-term bypass patency rates were 86.7% (13/15). Nonetheless, there was no bypass surgery related morbidity due to occlusion of the graft. Conclusion : Revascularization technique is a pivotal armament in managing complex aneurysms and scrupulous prior planning is essential to successful outcomes.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.741-750
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• 2007

Objective : This study investigated the relationship between diet and lifestyle and Sasang constitution (SC) in acute stroke patients. Methods : From October 2005 to March 2007, 379 acute stroke patients were included. Patients were hospitalized within 14 days after the onset of stroke at DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital or Department Cardiovascular and Neurologic Diseases (stroke center), Kyung Hee University Oriental hospital. We assessed the type of SC of acute stroke patients by Questionnaire for Sasang Constitution Classification II (QSCC II). We investigated general characteristics, stroke types, dietary preferences (meat, sea food, fast food, alcohol drinking, coffee and green tea drinking) and lifestyle (smoking, exercise) according to SC. Results : This study showed that out of the total patients, the proportion of So-yang to Tae-eum to So-eumwas equal to 2.6 to 2 to 1. Of note, this study showed a higher proportion in age of So-eum & weight of Tae-eum. The ratio of cerebral hemorrhage to cerebral infarction was 1 to 9. SVO, LAA, SUE are the 3 types of cerebral infarction classified by TOAST; SVO ranked the highest while SUE ranked the lowest in all constitutions. There were no significant differences between So-yang and Tae-eum in the aspect of the preference for meat, but the majority of So-eum displayed high preferences for seafood. In the aspect of alcohol drinking and smoking history, So-yang recorded significantly bigger proportion while So-eum & Tae-eum patients represented a bigger proportion than So-yangin the aspect of no exercise habits. Conclusion : According to the result above, we could observe the general disposition of various characteristic distributions according to SC of acute stroke patients. Also, we could observe a relationship between diet and lifestyle and Sasang constitution (SC) in acute stroke patients. Further studies will be needed to better understand the relationship between diet and lifestyle and Sasang constitution (SC) in acute stroke patients.