• Title/Summary/Keyword: Cerebrovascular Disorders

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Requirements for Cerebrovascular Surgery in Comprehensive Stroke Centers in South Korea

  • Kim, Tackeun;Oh, Chang Wan;Park, Hyeon Seon;Lee, Kunsei;Lee, Won Kyung;Lee, Heeyoung
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.478-484
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    • 2018
  • Objective : Cerebrovascular disease (CVD) was the third most common cause of death in South Korea in 2014. Evidence from abroad suggests that comprehensive stroke centers play an important role in improving the mortality rate of stroke. However, surgical treatment for CVD is currently slightly neglected by national policy, and there is still regional imbalance in this regard. For this reason, we conducted a survey on the necessity of, and the requirements for, establishing regional comprehensive cerebrovascular surgery centers (CCVSCs). Methods : This investigation was performed using the questionnaire survey method. The questionnaire was consisted with two sections. The first concerned the respondent's opinion regarding the current status of demand and the regional imbalance of cerebrovascular surgery in South Korea. The second section asked about the requirements for establishing regional CCVSCs. We sent the questionnaire to 100 board members of the Korean Society of Cerebrovascular Surgeons. Results : Most experts agreed that cerebrovascular surgery patients were concentrated in large hospitals in the capital area, and 83.6% of respondents agreed that it was necessary to alleviate the regional imbalance of cerebrovascular surgery. With regards to personnel, over 90% of respondents answered that at least two neuro-vascular surgeons and two neuro-interventionists are necessary to establish a CCVSC. Regarding facilities, almost all respondents stated that each CCVSC would require a neuro-intensive care unit and hybrid operating room. The survey asked the respondents about 13 specific neurovascular surgical procedures and whether they were necessary for a regional CCVSC. In the questions about the necessity of cerebrovascular surgical equipment, all seven pieces of equipment were considered essential by all respondents. A further five pieces of equipment were considered necessary on site: computed tomographic angiography, magnetic resonance angiography, conventional angiography, surgical microscope, and surgical navigation. Our results may provide a basis for future policy regarding treatment of cerebrovascular disease, including surgery. Conclusion : Raising the comprehensiveness of treatment at a regional level would lower the national disease burden. Policies should be drafted regarding comprehensive treatment including surgery for cerebrovascular disease, and related support plans should be implemented.

Two Cases of Systemic Lupus Erythematosus with Cerebrovascular Involvement (뇌 혈관계를 침범한 전신성 홍반성 루푸스 2례)

  • Kim, Bong-Jun;Lee, Eun-Young;Hong, Young-Hoon;Park, Ki-Do;Song, Young-Doo;Lee, Choong-Ki;Shim, Young-Ran
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.371-380
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    • 1998
  • Systemic lupus erythematosus(SLE) is an autoimmune disease which may affect many different organs and disclose various clinical manifestations. Recently central nervous system(CNS) involvement has been recognized as an increasingly significant contributor to morbidity and mortality of SLE. The clinical manifestations of CNS-lupus are highly variable and range from mild cognitive dysfunction, movement disorder, headache, psychosis to life-threatening stroke and coma. Among the neuropsychiatric disorders encountered in patients with SLE, cerebrovascular disease has been a relatively rare complication. The diagnosis and management of CNS-lupus is difficult because of the lack of useful diagnostic methods. If cerebrovascular involvement is suspected, aggressive treatment such as high dose steroid, immunosuppressive therapy, plasma exchange may be required to reduce high mortality rate. We experienced 2 cases cerebrovascular dis eases occurring in SLE patients which presented with various neuropsychiatric manifestations. They were diagnosed as CNS-lupus by neuropsychiatric symptoms, brain MRI, and BEG, and showed good response to high dose steroid pulse therapy.

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Relationship between Smoking and Sleep Disturbance (흡연과 수면장애의 관계)

  • Bae, Sanghyeok;Kim, Hong Soon;Kang, Seung-Gul
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.45-50
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    • 2018
  • Smoking is one of the most harmful causes of disease. Many previous researches have shown that cigarette smoking leads to cardiovascular, respiratory, oncologic, and cerebrovascular diseases. In addition to such adverse effects, the literature indicates that cigarette smoking can worsen sleep quality and induce sleep disorders. This review focuses on the relationship between smoking/nicotine and sleep and sleep disorders of insomnia, obstructive sleep apnea, and restless legs syndrome. Because smoking is a behavioral pattern that can be changed, it is important to quit smoking to improve overall health and sleep.

Association Rules of Comorbidities in Dementia by Using Korea National Hospital Discharge In-depth Injury Survey Data

  • Kim, Mijung
    • International journal of advanced smart convergence
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    • v.11 no.1
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    • pp.127-133
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    • 2022
  • This study aims to find out the associative relationship between dementia and comorbidities. To conduct this study, we used KNHDIS(Korea National Hospital Discharge In-depth Injury Survey) data from 2009 to 2018 provided by the KDCA(Korean Disease Control and Prevention Agency) annually. We used MySQL for data preprocessing and R for data analysis. As a result of applying the Apriori algorithm criteria of support(≥0.01), confidence(≥ 0.6), and lift(>1), seventeen rules related to dementia were discovered. The diseases associated with dementia were diabetes mellitus, hypertension, disorders of lipoprotein metabolism, glomerular disorders in diabetes mellitus, renal diseases, cardiovascular disease, cerebrovascular disease, and other urinary system disorders. This study can be utilized as primary data for the care of patients with dementia and provides implications for improving effective dementia prevention policies.

Health Literacy and Health Behaviors among Older Adults with Cardio-cerebrovascular Disease Residing in Rural Areas (농촌 지역 심뇌혈관질환 노인의 건강정보이해능력과 건강행위)

  • Lee, Myung Suk
    • Korean Journal of Adult Nursing
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    • v.29 no.3
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    • pp.256-265
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    • 2017
  • Purpose: The aim of this study was to identify levels of health literacy and reported health behaviors among older adults with cardio-cerebrovascular disease residing in rural areas. Methods: A cross-sectional survey was conducted with a convenience sample of 134 older people (mean age=75.5 years, 71.6% Female) registered at seven health centers. The structured questionnaires were used to measure levels of health literacy and health behaviors. Results: The average functional health literacy score was $6.08{\pm}3.04$, and the health behavior score was $62.92{\pm}6.45$. Respectively health behavior was positively associated with health literacy. Education, economic status, number of family members, number of social activities and health literacy were contribution factors explaining 40.64% of the variance in health behavior. Health literacy specifically explained 12.5% of health behavior. Conclusion: These findings suggest that strategies for improving health behaviors and reducing health inequalities may benefit from adopting a stronger focus on health literacy within prevention, patient education, and other public health interventions. Further longitudinal studies are needed to help confirm that improving health literacy in the elderly may be effective in changing health behaviors.

A Case Report of Multi-Infarct Dementia(MID) treated by scalp acupuncture (두침을 이용한 다발 경색성 치매 치험 1례)

  • Hwang, Jung-Su;Ahn, Young-Min;Kim, Hyeong-Seok;Jang, Hae-Young;Park, Hee-Soo;Kang, Hyun-Min
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.2
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    • pp.237-243
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    • 2006
  • Dementia is a syndrome characterized by a decline in multiple fields of cognitive domains. One of etiology of dementia is cerebrovascular disease. This is a case of multi-infarct dementia(MID) patient with functional mental disorders. The patient was treated with scalp acupuncture. After treatment, improvement was seen in cognitive domains.

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A Meta-analysis on the Risk Factors of Cerebrovascular Disorders in Koreans (한국인 뇌혈관질환의 위험요인에 관한 메타분석)

  • Park, Jong-Ku;Kang, Myung-Guen;Kim, Chun-Bae;Kim, Ki-Soon;Jee, Sun-Ha
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.1 s.60
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    • pp.27-48
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    • 1998
  • This study was conducted to integrate the results of studies which evaluated or identified the risk factors of CVD(cerebrovascular disorders) for Koreans. We retrieved the literature published in Korean by manual search and the English literature by Medline database to identify studies on the relationship between reported risk factors and CVD conducted for the Korean from 1980 to August, 1997. Hypertension and total serum cholesterol were selected as subjects of quantitative meta-analysis on risk factors of CVD in Koreans. The overall effect sizes of the risk of CVD due to hypertension and total serum cholesterol were calculated by common odds ratio(OR) and average standardized mean difference, retrospectively. Before the integration of each effect sizes into common effect sizes, the heterogeneity tests were conducted. Also, sensitivity tests were conducted for the estimated common effect sizes. Regarding hypertension and CVD, a total of 9 epidemiologic studies were identified with a total of 2,271 cases of CVD. The overall OR of hypertension associated CVD was 4.10(95% confidence interval[CI] 3.56 to 4.71). The OR of hypertension associated with hemorrhagic CVD and ischemic CVD were 6.56(95% CI : 4.92 to 8.80) and 3.28 (95% CI : 2.77 to 3.90), retrospectively. The OR of hypertension in relation to hemorrhagic CVD was significantly higher than that of hypertension in relation to overall CVD or ischemic CVD. Regarding total serum cholesterol and ischemic CVD, total 9 epidemiologic studies were identified with a total of 843 cases of ischemic CVD. Average mean difference as an effect size was 0.76, which was judged an important value according to Cohen's criteria. Our data suggested that hypertension was an important risk factor of overall CVD and its subtypes, and that the total serum cholesterol was associated with ischemic CVD in Koreans. For the lack of reliable prospective studies, however, we concluded that further research designed longitudinally would be required in this area.

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Risk Factors for Cerebrovascular Disorders in Koreans (뇌혈관질환 발생 위험요인 구명을 위한 코호트내 환자-대조군 연구)

  • Park, Jong-Ku;Kim, Ki-Soon;Lee, Tae-Yong;Lee, Duk-Hee;Koh, Kwang-Wook;Lee, Kang-Sook;Jee, Sun-Ha;Suh, Il;Ryu, So-Yeon;Park, Kee-Ho;Kim, Chun-Bae
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.2
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    • pp.157-165
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    • 2001
  • Objectives : To identify the risk factors of cerebrovascular disorders(CVD) in Koreans using a nested case-control study. Methods : The cohort consisted of beneficiaries who had taken health examinations of the Korea Medical Insurance Corporation (KMIC cohort: 115,600 persons) in 1990 and 1992 consecutively. Four hundred and twenty five (425) cases were selected following the validation of diagnosis among 2,026 reported CVD (160-168) inpatients during the year from 1993 to 1997. Controls were matched (1:1) with age and gender of the cases among inpatients without CVD during the same period. The source of data in this study were the files of the 1990 health examinations and the 1992 health questionnaires, as well as an additional telephone survey undertaken from March to November 1999. Results : In a bivariate analysis and multiple logistic regression analysis, risk factors for total CVD were hyperglycemia and hypertension. Unrespectively, the odds ratio of ex-smoker was significantly lower than that of those who had never smoked. The risk factors for ischemic CVD also were hyperglycemia and hypertension. However, only blood pressure was found to be a risk factor for hemorrhagic CVD. Hypercholesterolemia was not a risk factor for total CVD, ischemic CVD, and hemorrhagic CVD. Conclusion : We concluded that the most important risk factor for CVD (including subtype) in Koreans was hypertension.

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Four-Year Experience Using an Advanced Interdisciplinary Hybrid Operating Room : Potentials in Treatment of Cerebrovascular Disease

  • Jeon, Hong Jun;Lee, Jong Young;Cho, Byung-Moon;Yoon, Dae Young;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.35-45
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    • 2019
  • Objective : To describe our experiences with a fully equipped high-end digital subtraction angiography (DSA) system within a hybrid operating room (OR). Methods : A single-plane DSA system with 3-dimensional rotational angiography, cone-beam computed tomography (CBCT), and real-time navigation software was used in our hybrid OR. Between April 2014 and January 2018, 191 sessions of cerebrovascular procedures were performed in our hybrid OR. After the retrospective review of all cases, the procedures were categorized into three subcategorical procedures : combined endovascular and surgical procedure, complementary rescue procedure during intervention and surgery, and frameless stereotaxic operation. Results : Forty-nine of 191 procedures were performed using hybrid techniques. Four cases of blood blister aneurysms and a ruptured posterior inferior cerebellar artery aneurysm were treated using bypass surgery and endovascular trapping. Eight cases of ruptured aneurysm with intracranial hemorrhage (ICH) were treated by partial embolization and surgical clipping. Six cases of ruptured arteriovenous malformation with ICH were treated by Onyx embolization of nidus and subsequent surgical removal of nidus and ICH. Two (5.4%) of the 37 cases of pre-mature rupture during clipping were secured by endovascular coil embolization. In one (0.8%) complicated case of 103 intra-arterial thrombectomy procedures, emergency surgical embolectomy with bypass surgery was performed. In 27 cases of ICH, frameless stereotaxic hematoma aspiration was performed using $XperGuide^{(R)}$ system (Philips Medical Systems, Best, the Netherlands). All procedures were performed in single sessions without any procedural complications. Conclusion : Hybrid OR with a fully equipped DSA system could provide precise and safe treatment strategies for cerebrovascular diseases. Especially, we could suggest a strategy to cope flexibly in complex lesions or unexpected situations in hybrid OR. CBCT with real-time navigation software could augment the usefulness of hybrid OR.

Detection of Cerebrovascular Disease in a Child with Hutchinson-Gilford Progeria Syndrome Using MR Angiography: A Case Report (Hutchison-Gilford 조로증 증후군 환아에서의 뇌 자기공명 혈관조영술 소견: 증례 보고)

  • Jae Ho Lee;Ha Young Lee;Myung Kwan Lim;Young Hye Kang
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1360-1365
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    • 2022
  • Hutchinson-Gilford progeria syndrome (HGPS) is a rare, progressive, premature aging syndrome with early morbidity due to cardiovascular and cerebrovascular diseases. Clinical symptoms are very diverse, including non-specific symptoms such as growth retardation, scleroderma, alopecia, and osteoporosis, as well as hypertension and cardiovascular diseases that occur in childhood and adolescence due to accelerated vascular aging. In patients with HGPS, MR angiography is recommended for early diagnosis of asymptomatic stroke or vascular changes and to assess increased risk of cerebrovascular disease. We report the second domestic case of HGPS confirmed by genetic analysis in a 5-year-old child with typical clinical features, and the first English case report in Korea to present brain MR angiography findings.