• Title/Summary/Keyword: Cerebrovascular Infarction

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Comparative Study of the Effect of Man Geum Tang and Bo Yang Whan O Tang as a General Prescription for the Treatment of Motor Disturbance in Sequelae of Cerebrovascular Disease (졸중풍(卒中風) 후유증(後遺症)에 의한 운동장애(運動障碍) 환자(患者)의 치료(治療)를 위한 통용방(通用方)으로서 만금탕(萬金湯)과 보양환오탕(補陽還五湯)의 효과(效果)에 관한 비교(比較) 연구(硏究))

  • Kim, Dong-Woung
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.233-240
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    • 1994
  • Cerebrovascular disease(CVD) is marked by loss of consciousness. facial palsy and hemiparesis. Although being treated properly in acute stage. CVD is accompanied by various sequelae. So treatment of sequelas is great importance as much as in acute stage. Man Geum Tang(MGT) and Bo Yang Whan O Tang(BYWOT) are representative general prescription for sequelae of CVD. This study is to clarify comparatively the efficiency of MGT and BYWOT. 110 Patients who were administrated with either MGT or BYWOT over 2 weeks for treatment of CVD divided into 2 groups:53 patients(27 males and 26 fomales. average $63.58{\pm}9.48$ years old) adminstated with MGT and 57 patients (32 males and 25 females. average $65.84{\pm}8.93$ years old) with BYWOT. In the patients administrated with MGT. 15 patients were with cerebral hemorrhage and 38 patients were with cerebral infarction. 57 BYWOT group consisted of 27 patients with cerebral hemorrhage and 30 patients with cerebral infarction. MGT with cerebral hemorrhage and 30 patients with cerebral infarction. MGT was administrated for $15.18{\pm}2.43$days and BYWOT for $14.24{\pm}1.24days$. Motor improved significantly(9〈0.005) from grade after administration in upper and lower extremities respectively. In view of comparative effeciency. the grade of motor disturbance after administration in upper extremities showed insignificant(p〉0.005) change to $1.19{\pm}1.18\;and\;0.89{\pm}1.13$ in MGT and BYWOT group respectively. In lower extremities. the grade changed insignificantly (p〉0.05) to $1.26{\pm}1.08\;and\;1.18{\pm}1.10$ respectively. In the patients group with cerebral infarction. the grade of motor disturbance in MGT and BYWOT administration groups respectively were $0.84{\pm}0.14\;and\;0.60{\pm}0.15$ in upper exemities and $0.89{\pm}0.14\;and\;0.90{\pm}0.17$ in lower extremities. The significant difference between two groups didn't appeared. In cerebral hemorrhage patients the grade of motor disturbance were in upper extremities $2.07{\pm}0.33$ in MGT group and $1.59{\pm}0.29$ in BOWOT group and $2.20{\pm}0.26\;and\;1.59{\pm}0.28$ in lower extremities respectively. The difference between two groups were insignificant(p〉0.05).

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Outcomes of Mechanical Thrombectomy in Patients with Large Diffusion-Weighted Imaging Lesions

  • Cho, Yong-Hwan;Choi, Jae Hyung
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.22-29
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    • 2022
  • Objective : Despite many advancements in endovascular treatment, the benefits of mechanical thrombectomy (MT) in patients with large infarctions remain uncertain due to hemorrhagic complications. Therefore, we aimed to investigate the efficacy and safety of recanalization via MT within 6 hours after stroke in patients with large cerebral infarction volumes (>70 mL). Methods : We retrospectively reviewed the medical data of 30 patients with large lesions on initial diffusion-weighted imaging (>70 mL) who underwent MT at our institution within 6 hours after stroke onset. Baseline data, recanalization rate, and 3-month clinical outcomes were analyzed. Successful recanalization was defined as a modified treatment in cerebral ischemia score of 2b or 3. Results : The recanalization rate was 63.3%, and symptomatic intracerebral hemorrhage occurred in six patients (20%). The proportion of patients with modified Rankin Scale (mRS) scores of 0-3 was significantly higher in the recanalization group than in the non-recanalization group (47.4% vs. 9.1%, p=0.049). The mortality rate was higher in the non-recanalization group, this difference was not significant (15.8% vs. 36.4%, p=0.372). In the analysis of 3-month clinical outcomes, only successful recanalization was significantly associated with mRS scores of 0-3 (90% vs. 50%, p=0.049). The odds ratio of recanalization for favorable outcomes (mRS 0-3) was 9.00 (95% confidence interval, 0.95-84.90; p=0.055). Conclusion : Despite the risk of symptomatic intracerebral hemorrhage, successful recanalization via MT 6 hours after stroke may improve clinical outcomes in patients with large vessel occlusion.

A Clinical study on the patients of Brain stem infarction (뇌간경색환자에 대한 임상적 고찰)

  • Park, Kyu-Taek;Kim, Young-Kyun;Kwon, Jung-Nam;Park, Sook-Ja
    • The Journal of Internal Korean Medicine
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    • v.21 no.5
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    • pp.729-738
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    • 2000
  • Objective : We examined patients admitted to Dong Eui University Oriental Medical Hospital from 1st January to 31st December in 2000. We studied 110 cases of patients who were diagnosed as Brain stem(pons, mid brain, medullar) infarction with brain CT, MRI scan, MR Angiography. Methods : We analyzed patients into sex, age, onset time, invasion lesion, past and family history, risk factor, abnormal vital sign for early 2 weeks, prodromal symptoms, symptoms at entry, progress and incidental symptoms at acute stage, complications, the state of condition at discharge, demonstrations, herb medications, western and oriental medical cooperation and admission period. Results : Our study was similar to existing studies in the distribution of sex, age, past and family history and risk factors. But there was some differences in the prodromal symptoms, symptoms at entry progress and incidental symptoms at acute stage, and the state of condition at discharge. Conclusions : Our study shows the brain stem infarction patients differed from other cerebrovascular accident patients in the symptoms. We hoped that our study would be further studied in western and oriental medicine.

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The Case-Control Study of Risk Factors of Silent Cerebral Infarction (무증상 뇌경색의 위험요인에 대한 환자;대조군 연구)

  • Baek, Hye-Ki;Ko, Mi-Mi;Yu, Byeong-Chan;Bang, Ok-Sun;Oh, Yeong-Seon;Kim, Yeon-Jin;Kim, Jung-Hyun;Kim, Yoon-Sik;Seol, In-Chan
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.850-862
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    • 2007
  • Background : Cerebrovascular disease is a major cause of death and disability in adults. Silent cerebral infarction (SCI) portends more severe cerebral infarction or may lead to insidious progressive brain damage resulting in vascular dementia. Known cardiovascular risk factors, such as arterial hypertension, diabetes mellitus, smoking, hyperlipidemia and ischemic heart disease may increase the risk of SCI. This study was designed to evaluate the risk factors of SCI in an apparently normal adult population. Methods : We divided 340 neurologically normal adults (mean age=59.90$\pm$8.30, men:women = 146:194) who underwent brain computed tomography (CT) or magnetic resonance imaging (MRI) at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital in two groups, Silent inf. and Controls,and analyzed risk factors of SCI by interview, physical examination and blood test. Risk factors of SCI were assessed by interview, physical examination and blood test. We performed Pearson's chi-square test and two-sample t-test for univariate analysis and multiple logistic regressions for multivariate analysis to evaluate risk factors of SCI. Results : Old age, diabetes mellitus, and high lactate dehydrogenase (LDH) levels were associated with SCI on univariate analysis. Diabetes mellitus was demonstrated to be an independent risk factor for SCI on multivariate analysis. Conclusions : Advanced age, diabetes mellitus, and LDH levels are associated with SCI.

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Late-Onset Group B Streptococcal Meningitis Complicated with Extensive Cerebral Infarction (광범위한 뇌경색증이 합병된 지발형 B군 사슬알균에 의한 수막염 증례)

  • Cho, Min Su;Kim, Yongmin;Cho, Hye-Kyung;Choi, Soo-Han
    • Pediatric Infection and Vaccine
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    • v.25 no.1
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    • pp.45-49
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    • 2018
  • Group B streptococcus (GBS) is the leading cause of neonatal morbidity and mortality. Late-onset GBS disease commonly manifests as occult bacteremia or meningitis. Approximately 50% of survivors of late-onset meningitis have long-term neurologic sequelae. Cerebrovascular complications are often associated with unfavorable clinical outcomes of GBS meningitis. There have been a few reports of cerebral infarction accompanied by GBS meningitis. We report a 29-day-old girl with severe, widespread cerebral infarction due to late-onset GBS meningitis. Isolated GBS strain from this patient was serotype III, ST-19. Currently, she has cortical blindness and significant developmental delay.

Quantitative Analysis of Regional Cerebral Blood Flow Using $^{99m}Tc-HMPAO$ SPECT in Cerebrovascular Disease (뇌혈관질환에서 $^{99m}Tc-HMPAO$ SPECT를 이용한 국소뇌혈류의 정량적 분석)

  • Lee, Myung-Chul;Lee, Myung-Hae;Koh, Chang-Soon;Roh, Jae-Kyu;Myung, Ho-Jin;Lee, Sun-Ho;Han, Dae-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.1
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    • pp.15-19
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    • 1988
  • SPECT of regional cerebral blood flow was performed using $^{99m}Tc-HMPAO$ in 28 patients with cerebrovascular disease and quantitative analysis was done. Cerebral asymmetry index and percent index of asymmetry of cerebellar hemisphere of patients with cerebral infarction or ischemia were $0.764{\pm}0.576$ and $-5.6{\pm}7.1%$ and those of intracranial hemorrhage was $0.416{\pm}0.251$ and $-2.5{\pm}4.1%$ respectively. According to PIA of cerebellar hemisphere, 12 patients showed crossed cerebellar diaschisis. $^{99m}Tc-HMPAO$ SPECT seemed to be a useful tool for the evaluation of regional cerebral blood flow.

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Knowledge on Cardio-cerebrovascular Disease and Health Behaviors among Middle-aged Postmenopausal Women at Risk (심뇌혈관질환 위험인자를 가진 폐경 중년여성의 질환예방 지식과 건강행위)

  • Kim, Kyung Ae;Hwang, Seon Young
    • Korean Journal of Adult Nursing
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    • v.28 no.4
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    • pp.424-435
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    • 2016
  • Purpose: This study examined knowledge about cardio-cerebrovascular disease (CVD) and its relationship to health behaviors among middle-aged postmenopausal women with CVD risk factors. Methods: The study was a cross-sectional descriptive study. One hundred and thirty-six postmenopausal women were recruited from outpatient departments of four hospitals. The women were $60.69{\pm}6.5$ years old. Self-reported questionnaires were administered, and waist-hip ratios (WHR) were measured. Results: Among the women, 72.8% reported hypertension, 19.1% reported diabetes, 33.8% reported hypercholesterolemia, and 24.2% reported angina pectoris. Moreover, 73.9% of the women reported not knowing of CVD prevention, and only 26.1% reported exercising regularly. A majority of the women (80.9%) had a WHR > 0.85. Multiple linear regression analysis after adjusting for age and marital status indicated that the risk of myocardial infarction and stroke increased (p<.001). Waist-hip ratio${\leq}0.85$ (p=.022) and living with family members (p=.006) were significant predictors of healthier behaviors ($R^2$=0.21, p<.001). Knowledge of CVD and health behaviors were not correlated. Conclusion: Obese women and women who live alone are no more likely to practice health behaviors aimed at CVD prevention than their counterparts in the sample. Education and exercise interventions are needed, especially for obese women, to promote healthy behaviors among middle-aged postmenopausal women with CVD risk factors.

Review of Clinical Research about the Treatment of Aphasia after Cerebrovascular Disease (뇌혈관질환 후 실어증의 한의학적 치료에 대한 국내 임상연구에 대한 고찰)

  • Koh, Ji-yoon;Son, Ah-hyun;Shin, Hyeon-su
    • The Journal of Internal Korean Medicine
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    • v.39 no.6
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    • pp.1105-1115
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    • 2018
  • Objectives: The aim of this review is to investigate clinical studies on Oriental medicine treatment for aphasia after cerebrovascular disease. Methods: Using the keywords 'Aphasia', 'Oriental medicine', 'Stroke' 'Cerebral infarction', 'Cerebral hemorrhage', and 'Clinic', we searched domestic databases, including "NDSL (National Discovery for Science Leaders)", "Korean Traditional Knowledge Portal", "OASIS (Oriental Medicine Advanced Searching Integrated System)", and "RISS (Research Information Sharing Service)". Each keyword was not searched individually, but combined in various ways. To investigate recent trends, we limited our search to papers published after 2000. Papers that did not include a specific treatment method or did not match the subject "Aphasia after stroke" were excluded. Results: Using the searching method, 13 studies were found. Of these, 12 studies were in the form of case reports, while one was in the form of a non-randomized controlled trial. These studies showed positive results for the use of Oriental medicine in terms of the Korean version of the Western Aphasia Battery (K-WAB), the evaluation form on functional performance capability and accuracy of articulatory organs developed by Lee, aphasia screening test refered in 'Assessment in Speech-Language Pathology' and adapted properly to Korean, the Communicative Ability in Daily Living Test (CADLT), the Korean Version-Boston Naming Test (K-BNT), and language assessment items included in CNS, and NIHSS. Conclusions: Of the 12 case reports, 11 studies showed positive results of the use of Oriental medicine for treatment of aphasia after cerebrovascular disease. However, more sophisticated and large-scale clinical research on aphasia should be conducted.

The Effect of Sosokmyung-tang extract on Global cerebral ischemia·Cerebral Infarction by MCA occlusion in vivo (소속명탕(小續命湯) 추출물(抽出物)이 전뇌허혈(全腦虛血)및 국소뇌허혈(局所腦虛血)에 미치는 영향(影響))

  • Lee, Kyung-Ae;Shin, Gil-Cho;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.1
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    • pp.107-116
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    • 1999
  • The effects of Sosokmyung-tang(小續命湯) on global cerebral ischemia and cerebral in farction by MCA(middle cerebral artery) occlusion were evaluated in this study. This study was performed to investigate that Sosokmyung-tang would be useful for cerebrovascular diseases. In the case of global cerebral ischemia, ICR mice were used and divided into three group at random. Control group was treated after oral administration of normal saline, experimental group was treated after oral administration of 10.4mg/20g/day of Sosokmyung-tang extract. The multiple parameter of global cerebral ischemia included the duration of coma of KCN(potassium cyanide)-injected(1.2mg/kg, i.v) group and the survival time of KCN-injected(3.0mg/kg, i.v) group. In the case of cerebral infarction by MCA occlusion, Sprague-Dawley rats were used and divided into three group at random. Control group was given nothing before MCA occlusion, experimental group was given 157.2mg/250g/day of Sosokrnyung-tang extract before MCA occlusion. We investigated edema and ischemic ratio in 8 slices of rats' brain after MCA occlusion. The results were obtained as follows : 1. Sosokrnyung-tang significantly shortened the duration of coma of KCN-injected(1.2mg/kg,i.v) group and lengthened the survival time of KCN-injected(3.0mg/kg, i.v) group. 2. Sosokmyung-tang significantly decreased cerebral edema and ischemic ratio in rats after MCA occlusion. From the above results, it was concluded that Sosokmyung-tang can be effectively applied to cerebrovascular diseases.

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Indirect revascularization surgery for moyamoya disease in children and its special considerations

  • Wang, Kyu-Chang;Phi, Ji Hoon;Lee, Ji Yeoun;Kim, Seung-Ki;Cho, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.11
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    • pp.408-413
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    • 2012
  • Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.