• 대한본초학회지
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• 제26권4호
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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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• 제66권6호
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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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• 제29권8호
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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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• 제60권1호
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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.

• 대한영상의학회지
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• 제83권1호
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• pp.199-205
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• 2022

뇌정맥발달기형은 일반적으로 증상을 유발하지 않는 흔한 두개 내 혈관 기형이다. 뇌정맥발달기형과 관련된 출혈은 동반된 해면상 기형이 원인인 경우가 대부분인 것으로 알려져 있으며, 뇌정맥발달기형 내 혈전증이 뇌출혈을 일으킨 경우는 극히 드물게 보고되어 있다. 저자들은 혈전증을 유발할 수 있을 것으로 보이는 특이한 구조의 뇌정맥발달기형을 가진 환자에서 혈전증과 큰 뇌출혈이 생긴 1예를 경험하였기에 컴퓨터단층촬영 소견과 자기공명영상 소견을 보고하고자 한다.

• The Journal of Korean Physical Therapy
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• 제10권1호
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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.

• 한국멀티미디어학회논문지
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• 제20권12호
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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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• 제30권3호
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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.

• 대한핵의학회지
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• 제32권5호
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• pp.397-402
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• 1998

목적: 대뇌피질의 구조적 병변이 없는 기저핵 혈종환자에 있어서, 대뇌와 소뇌의 해리 현상에 관해 알아보고자하였다. 대상 및 방법 : CT와 MRI상 혈종이 기저핵에 국한되고, 대뇌 피질의 구조적 병변이 없는 12명의 환자를 대상으로 하였다. Tc-99m ECD PECT검사가 전 예에서 시행되었고, 대조군으로 MRI상 구조적 병변이 없고 SPECT 검사상 육안적으로 정상 소견을 보인 20명의 정신과 환자가 선택되었다. 해리 현상에 의한 rCBF의 변화를 육안적으로 확인하였고, 반정량적 분석을 위해 asymmetric index (AI)를 이용하였다. AI가 기저핵, 시상, 소뇌와 대뇌 피질 (전두엽, 측두엽, 두정엽)에서 측정되었고, 대조군 AI의 (평균+2X표준편차)보다 큰 AI를 가지는 경우를 저혈류로 정의하였다. 결과: 환자군에서 측정된 소뇌와 대뇌 피질의 평균 AI는 대조군과 비교하여 통계학적으로 의미 있게 큰 수치를 보였다 (p<0.05): 소뇌 ($18.68{\pm}8.94$ vs $4.35{\pm}0.94$, 평균 표준표차), 시상 ($31.91{\pm}10.61$ vs $2.51{\pm}1.45$), 기저핵 ($35.94{\pm}16.15$ vs $4.34{\pm}2.08$), 두정엽 ($18.94{\pm}10.69$ vs $3.24{\pm}0.87$), 전두엽 ($13.60{\pm}10.8$ vs $4.02{\pm}2.04$), 측두엽 ($18.92{\pm}11.95$ vs $5.13{\pm}1.69$). 12명의 환자 중 혈종의 반대측 소뇌(10명), 동측 시상 (12명) 동측 두정엽 (12명), 전두엽 (6명), 측두엽 (10명)에서 육안적으로 또한 AI를 이용한 반정량적 분석상 의미 있는 저혈류를 보였다. 결론: 교차소뇌해리 현상과 피질 해리 현상은 기저핵 혈종 환자에서 빈번하게 관찰되었다. 이는 교차 소뇌해리 현상이 기존에 알려진 피질 뇌교 소뇌로 (corticopontocerebellar tract)의 장애가 없이도 발생할 수 있다는 것을 시사한다.

• Journal of Korean Neurosurgical Society
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• 제48권4호
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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.