• Title/Summary/Keyword: Cerebrovascular Disorders

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Neuroimaging Findings of First-Visit Headache Patients (두통 초진 환자에서 신경영상검사 소견)

  • Kim, Byung-Su;Kim, Soo-Kyoung;Kim, Jae-Moon;Moon, Heui-Soo;Park, Kwang-Yeol;Park, Jeong Wook;Sohn, Jong-Hee;Song, Tae-Jin;Chu, Min Kyung;Cha, Myoung-Jin;Kim, Byung-Kun;Cho, Soo-Jin
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.294-301
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    • 2018
  • Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.

Level of Obstructive Sleep Apnea of Patients with Ischemic Cardio-cerebrovascular Disease and Affecting Factors (허혈성 심뇌혈관질환자에서 폐쇄성 수면무호흡증 정도 및 영향요인)

  • Kim, Sun Hwa;Hwang, Seon Young
    • The Journal of the Korea Contents Association
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    • v.18 no.4
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    • pp.114-127
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    • 2018
  • This study aimed to investigate the levels of Obstructive Sleep Apnea (OSA), health behavior and sleep quality and to examine the predictors of OSA in patients with ischemic cardio-cerebrovascular disease. 141 patients who were admitted to the vascular unit were recruited and surveyed using structured questionnaires. Saturation of Peripheral Oxygen (SpO2) was measured at three time points using a pulse oximeter. Data were analyzed using SPSS/WIN 20.0. The mean age of the subjects was $64.4{\pm}11.1$ years and 61% was men. The 21.3%(n=30) of the subjects were classified as high-risk for OSA by the cut point and 71.6%(n=101) had low sleep quality. OSA high-risk group showed significant difference in SpO2 in the middle of sleep (p=.006) and at the end of sleep (p=.004) compared to the low-risk group. Multiple logistic regression analysis showed that perceived frequent snoring, smoking, obesity, lack of exercise among health behavior were found as predicting factors on OSA. OSA or persistent snoring should be recognized as a cardiovascular risk factor in the cardiovascular nursing practice. In addition to early treatment of OSA, education and counseling should be provided to patients and their family for prevention of secondary recurrence.

High-Resolution Magnetic Resonance Imaging Findings of Reversible Cerebral Vasoconstriction Syndrome associated with Severe Anemia: A Case Report (중증 빈혈과 관련된 가역적 뇌혈관 수축 증후군의 고해상도 자기공명영상 소견: 증례 보고)

  • Yongsang Kim;Ra Gyoung Yoon;Ji Ye Lee;Jong-Moo Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.261-266
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    • 2021
  • Ischemic stroke is one of the manifestations of reversible cerebral vasoconstriction syndrome (RCVS). Many precipitants and associated disorders of RCVS have been suggested. However, few case reports have indicated an association between anemia and RCVS. Here, we report a case of a 66-year-old female with severe iron deficiency anemia (IDA), who presented with ischemic stroke and cerebral vasoconstriction, which gradually improved with conservative treatment. High-resolution vessel wall magnetic resonance imaging findings and reversibility suggested the possibility of RCVS. In patients with RCVS and ischemic stroke, IDA should be considered. Prompt management should be delivered to prevent disease progression and recurrence.

The Effect of Korean Medicine Treatment on Cerebral Infarction with Hemiplegia: A Case Report (아급성기 뇌경색 환자의 좌측 편마비에 대한 한의 치료 1례)

  • Oh, Ju-hyun;Sung, Jae-yeon;Seo, Hye-jin;Lee, Yu-ra;Song, Jin-young;Kong, Geon-sik;Kang, Man-ho;Lee, Hyung-chul;Eom, Guk-hyeon;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.990-998
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    • 2019
  • Introduction: Stroke refers to a sudden brain disease that results in disorders in the anatomy of the brain. The cause is a sudden circulatory disorder of the cerebrovascular system that creates a consciousness disorder and hemiplegia. Despite aggressive treatment after the onset, stroke is a social problem because the patient has difficulty in recovering from sequelae that can include limb movement disorders, language disorders, and emotional disorders. In this study, we describe the effect of traditional Korean medicine treatment on the sequelae in a subacute cerebral infarction patient admitted to a Korean medical hospital. Case presentation: A 67-year-old male patient was diagnosed with cerebral infarction circa 2005, and his condition had not improved. Around March 15, 2018, he experienced the sudden onset of a cerebral infarction in his daily life. This was confirmed by a brain MRI, and he was hospitalized at other hospitals, but he showed no improvement. We conducted a manual muscle test (MMT) to evaluate the patient's exercise and strength. His gait level was measured to evaluate his degree of walking. He was treated with Bojungikgi-tang and acupuncture twice a day. After 34 days of inpatient treatment, the patient's exercise strength improved from Grade 2+~Grade 3 to Grade 3+ determined by the MMT, and his walking ability improved from Gait Level 3 to Gait Level 4. Conclusion: The findings of this study indicate that acupuncture and herbal medicine treatment can help treat patients with hemiplegia due to cerebral infarction.

Clinical Study of Sanjoin- Tang on Insomnia Patients with Cerebrovascular Accident (뇌혈관 장애환자의 불면증에 대한 산조인탕의 치료효과에 대한 임상연구)

  • Hong Hyun Woo;Lee Sung Do;Gam Chul Woo;Park Dong Il
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.6
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    • pp.1927-1932
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    • 2004
  • This research study has been conducted to identify and evaluate the effectiveness of Sanjoin-Tang(酸棗仁湯) for insomnia relief. The clinical testing of Sanjoin-Tang(酸棗仁湯) was carried out at Oriental Medical Center of Dong-Eui University with the participation of 30 patients. The results of Sanjoin-Tang(酸棗仁湯) treatments show as follows: Change of total amount of sleep showed 1.75±2.23 hours of increase.(p-value=0.001, respectively) Change of average delaying bedtime before and after the treatment showed 1.57±2.50 hours of decrease.(p-value=0.001, respectively) Change of average bedtime arousal before and after the treatment showed 0.96±1.46 times of decrease. (p-value=0.004, respectively) Change of sleep quality after the treatment has improved. According to statistical results, Sanjoin-Tang(酸棗仁湯) has proven effective for reducing sleep disorders, and this, restoring normal sleep patterns.

Ginseng radix Suppresses Ischemia-induced Increase in c-Fos Expression and Apoptosis in the Hippocampal CA1 Region in Gerbils

  • Park, Keung-Ryol;Jang, Mi-Hyeon;Kim, Chang-Ju;Lee, Choong-Yeol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.1
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    • pp.224-229
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    • 2005
  • Ginseng radix, the root of Panax ginseng C.A.Meyer (Araliaceae), has traditionally been used for the treatment of various disorders including cerebrovascular accident (CVA). In the present study, the effect of Ginseng radix on c-Fos expression and apoptosis in the hippocampal CA1 region of gerbils following transient global ischemia was investigated via immunohistochemistry for c-Fos and caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Enhanced c-Fos-, TUNEL-, and caspase-3-positivities were detected in the hippocampal CA1 region in ischemic gerbils. Administration of the aqueous extract of Ginseng radix suppressed this ischemia-induced increment in the numbers of c-Fos-, TUNEL-, and caspase-3-positive cells. These results suggest that Ginseng radix has an inhibitive effect on the induction of c-Fos expression and apoptosis seen following transient global ischemia.

Randomized Clinical Controlled Trials with Herbal Acupuncture (Pharmacopuncture) in Korea - A Systematic Review (무작위 배정 비교 임상 시험을 통한 국내의 약침 연구에 대한 체계적 고찰)

  • Park, Bong-Ky;Cho, Jung-Hyo;Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.30 no.5
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    • pp.115-126
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    • 2009
  • Objective: By assessing the quality of methodology and synthesis of results of RCTs (Randomized Controlled Clinical Trials) with herbal acupuncture (pharmacopuncture), we hope to help with administrating herbal acupuncture therapy in clinic and conducting RCT with herbal acupuncture. Methods: Reports of RCT conducted in Korea published in medical journals until February 2009 were collected. We surveyed elementary information of RCTs, evaluated randomization, double-blinding, allocation concealment and put together the results of RCTs by seven clinical topics. Results: 38 RCTs with herbal acupuncture were selected, then adequate methods for randomization and allocation concealment were found in 39% and 5% of studies. Complete double-blinding and a clear accounting of all participants were conducted in 42% and 50% of reports. The synthesis of RCTs revealed that herbal acupuncture was useful and effective on degenerative gonarthritis, omarthralgia on cerebrovascular accident, acute ankle sprain, back sprain, neck sprain, headache, rheumatoid arthritis and tennis elbow, generally. Conclusions: Although further improvement in quality of methodology of RCTs with herbal acupuncture is required, clinical usefulness of herbal acupuncture was shown especially on disorders of musculoskeletal system via RCTs.

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FDG PET Imaging For Dementia (치매의 FDG PET 영상)

  • Ahn, Byeong-Cheol
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.102-111
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    • 2007
  • Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia, Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the diseases. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia.

Acute Respiratory Distress during Impression Taking in a TMJ Dislocation Patient with Pneumonia (폐렴을 동반한 턱관절 탈구환자에서 인상채득 중 유발된 급성 호흡장애)

  • Son, Jeong-Seog;Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.119-126
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    • 2014
  • Difficulty in breathing can be very disconcerting to a patient who is conscious yet unable to breath normally. The common causes of acute respiratory distress include hyperventilation, vasodepressor syncope, asthma, heart failure, and hypoglycemia. In most of these situations, the patient does not exhibit respiratory distress unless an underlying medical disorder becomes acutely exacerbated. Examples of this include acute myocardial infarction, anaphylaxis, cerebrovascular accident, hyperglycemia, and hypoglycemia. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Therefore, the most dental patient should be cared gently as the stress reduction protocol. This is a case report of acute respiratory distress with vasodepressor syncope during alginate impression taking of mandibular teeth in a long-standing temporomandibular joint dislocated 93-years-old pneumonic patient.

The Roles of Dietary Polyphenols in Brain Neuromodulation (뇌 신경조절에서의 식이 폴리페놀 화합물의 역할)

  • Lee, Hyeyoung;Lee, Heeseob
    • Journal of Life Science
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    • v.28 no.11
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    • pp.1386-1395
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    • 2018
  • Over recent years, it has become evident that the central nervous system bidirectionally interacts with the gastrointestinal tract along the gut-brain axis. A series of preclinical studies indicate that the gut microbiota can modulate central nervous system function through a multitude of physiological functions. Polyphenols are ubiquitous plant chemicals included in foods such as fruits, vegetables, tea, coffee and wine, and their consumption is directly responsible for beneficial health effects due to antioxidant, anti-inflammatory, antimicrobial, immunomodulatory, anticancer, vasodilating, and prebiotic-like effects. There is increasing evidence that dietary polyphenol can contribute to beneficial effects in neuronal protection acting against oxidative stress and inflammatory injury as well as in cognitive functions. In this paper, we overview the neuroprotective role of dietary polyphenols especially focusing on the neuroinflammation and neurovascular function by interaction with the gut microbiome. Polyphenol metabolites could directly act as neurotransmitters crossing the blood-brain barrier and modulating the cerebrovascular system or indirectly modulating gut microbiota. In addition, evidence suggests that dietary polyphenols are effective in preventing and managing neurological disorders, such as age-related cognitive decline and neurodegeneration, through a multitude of physiological functions. Dietary polyphenols are increasingly envisaged as a potential nutraceuticals in the prevention and treatment of neurological disorders, because they possess the ability to reduce neuroinflammation, to improve memory and cognitive function and to modulate the gut microbiota.