• 제목/요약/키워드: Corona radiata

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Motor Function Recovery in Stroke Patients with Corona Radiata Infarct: 4 Case Studies

  • Kim, Chung-Sun;Kwon, Jung-Won
    • The Journal of Korean Physical Therapy
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    • 제22권3호
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    • pp.31-35
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    • 2010
  • Purpose: The aim of this study was to use fMRI and clinical prognosis criteria to evaluate therapeutic interventions in stroke patients with corona radiata infarct and acquire fundamental information about recovery mechanisms. Methods: Four subjects (2 men, 2 women) who had strokes with corona radiata infarct were recruited. For all subjects, motor functions such as motricity index (MI), modified brunnstrom classification (MBC), functional ambulatory category (FAC), and bathel index (BI) were evaluated. Evaluations were done at least 4 times over a period of approximately 6~7 months from stroke onset. We compared the final evaluation with the first. Results: All patients with corona radiata infarct showed improvement in motor outcomes with the passing of time. The strength of all patients improved from zero or trace levels to normal or good levels in the MI (Motricity Index) test. Other motor outcomes including the modified brunnstrom classification (MBC), the functional ambulatory category (FAC), and the bathel index (BI) also improved with the passing of time. Conclusion: Stroke patients with corona radiata infarcts change for the better over time. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

A Comparative Study on Recovery of Motor Function in Stroke Patients with Corona Radiata Infarcts and Intracerebral Hemorrhage

  • Kim, Chung-Sun;Park, Sang-Young;Kwon, Jung-Won
    • The Journal of Korean Physical Therapy
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    • 제22권6호
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    • pp.53-58
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    • 2010
  • Purpose: Our goal was to determine the difference in motor recovery between two stroke types: the corona radiata (CR) infarct type and the intracerebral hemorrhage (ICH) type, by using assessment methods for motor functions. Methods: Forty subjects who were diagnosed as having had a stroke with an infarct (men: 11, women: 9, mean age: $62.25{\pm}7.59$) or a stroke with an ICH (men: 12, women: 8, mean age: $59.75{\pm}6.11$) were recruited. In all subjects, motor functions of the affected extremities were measured 2 times: at stroke onset (initial) and 6 months after the onset (final) by the motricity index (MI), the modified Brunnstrom classification (MBC), and functional ambulatory category (FAC). We compared the final assessment with the initial one. Results: Motor functions of all patients improved with the passing of time. All scores of motor function assessment in the ICH type were higher than in the infarct type. Comparing the initial assessment with the final one, upper MI and MBC scores of the upper extremities were significantly different between the two stroke types (p<0.05), but lower MI and FAC scores of the lower extremities were not (p>0.05). Conclusion: These findings imply that patterns of motor recovery in patients with either the infarct type or the ICH type of stroke change for the better over time. The degree of motor recovery in the ICH type was better than in the infarct type. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

기저핵-대뇌부챗살 뇌출혈로 인한 반신부전마비에 대한 한·양방 병행 치험 1례 (A Case Report on Hemiplegia in a Patient with an Intracerebral Hemorrhage of the Basal Ganglia of the Corona Radiata Treated with Traditional Korean and Western Medicine)

  • 정다해;길봉훈;김동훈;윤혜수;이은창;조혜미;한다영;손아현
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.1131-1141
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    • 2021
  • Objective: This study examined the case of a 63-year-old man with a history of hypertension and gout who had developed an intracerebral hemorrhage (ICH) of the right basal ganglia of the corona radiata. Methods: The patient was treated with herbal medicine (Boyanghwanoh-tang and powdered Oryeong-san extract), Western medicine (Anticonvulsants, antihypertensive drugs, psychotropic agents, and others), acupuncture, moxibustion, cupping, and rehabilitative therapy. Their effects were evaluated using the Manual Muscle Test (MMT), Korean version of the modified Barthel Index (K-MBI), National Institute of Health's Stroke Scale (NIHSS), and Modified Rankin Scale (mRS). Results: After treatment, the MMT grade improved from 3/3+ to 4+/4+. Additionally, the K-MBI score improved from 62 to 77. Conclusion: The results suggest that combined traditional Korean and Western medicine can effectively treat patients with ICH.

Recovery of an Injured Corticospinal Tract in a Patient With Infarction on the Corona Radiata

  • Lee, Sook;Lim, Hyoung-Won;Yeo, Sang-Seok
    • The Journal of Korean Physical Therapy
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    • 제27권1호
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    • pp.78-80
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    • 2015
  • Purpose: Many studies have attempted to elucidate the motor recovery mechanisms of stroke. In the current study, we report on a patient with infarction who showed recovery of an injured corticospinal tract (CST), using diffusion tensor imaging (DTI). Methods: A 20-year-old male presented with severe paralysis of the left extremities following an infarction in the right corona radiate and basal ganglia. The patient showed good motor recovery as much as being able to manipulate object using his left hand and could walk independently on stairs at 9 months after onset. Results: At 1 month after onset, the right CST showed decreased fiber volume due to the partial injury at the level of the corona radiate, and no (motor evoked potential) MEP was evoked from the right hemisphere. By contrast, the results at 9 months showed increased fiber volume of the right CST and the amplitude of MEP had improved to normal range on TMS. Conclusion: These results suggest that the severely injured right CST and MEP amplitude had been recovered during 9 months. Therefore, this result has important implications for brain plasticity and brain rehabilitation in patients with infarction.

Transcallosal Ipsilateral Motor Pathway from the Unaffected Hemisphere in a Patient with Traumatic Brain Injury

  • Jang, Woo-Hyuk;Lee, Mi-Young;Kwon, Yong-Hyun;Jang, Sung-Ho
    • The Journal of Korean Physical Therapy
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    • 제26권3호
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    • pp.216-219
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    • 2014
  • Purpose: We presented with a patient with traumatic brain injury who showed a transcallosal ipsilateral motor pathway from unaffected motor cortex to affected extremities, as evaluated by diffusion tensor tractography (DTT). Methods: One patient and six age-matched normal subjects were enrolled. A 42-year-old left hemiparetic male who suffered from brain injury by motor vehicle accident 9 years ago showed a leukomalactic lesion in the right corona radiata and parieto-temporal lobe. His left extremities were completely paralyzed initially, but recovered slowly over 2 years. At the time of the evaluation, he was able to grasp and release an object, and to walk with spastic gait pattern. DTT was performed using 1.5 T with a Synergy-L Sensitivity Encoding head coil. DTT was obtained with termination criteria of FA <0.2 and an angle change > $45^{\circ}c$. Results: The motor tracts of the unaffected (left) hemisphere of the patient and control subjects originated from the motor cortex and descended along the known corticospinal tract without any transcallosal tract. By contrast, the tract of the affected (right) hemisphere originated from the left premotor cortex, descended through the left corona radiata, and then crossed the mid-portion of the corpus callosum. The tract then descended through the known corticospinal tract pathway to the right medulla. Conclusion: We conclude that the transcallosal ipsilateral motor pathway from the unaffected hemisphere appeared to contribute to the motor recovery in this patient.

The Upper Ascending Reticular Activating System between Intralaminar Thalamic Nuclei and Cerebral Cortex in the Human Brain

  • Jang, Sungho;Kwak, Soyoung
    • The Journal of Korean Physical Therapy
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    • 제29권3호
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    • pp.109-114
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    • 2017
  • Purpose: The ascending reticular activating system (ARAS) is responsible for regulation of consciousness. In this study, using diffusion tensor imaging (DTI), we attempted to reconstruct the thalamocortical projections between the intralaminar thalamic nuclei and the frontoparietal cortex in normal subjects. Methods: DTI data were acquired in 24 healthy subjects and eight kinds of thalamocortical projections were reconstructed: the seed region of interest (ROI) - the intralaminar thalamic nuclei and the eight target ROIs - the medial prefrontal cortex, dorsolateral prefrontal cortex, ventrolateral prefrontal cortex, orbitofrontal cortex, premotor cortex, primary motor cortex, primary somatosensory cortex, and posterior parietal cortex. Results: The eight thalamocortical projections were reconstructed in each hemisphere and the pathways were visualized: projections to the prefrontal cortex ascended through the anterior limb and genu of the internal capsule and anterior corona radiata. Projections to the premotor cortex passed through the genu and posterior limb of the internal capsule and middle corona radiata; in contrast, projections to the primary motor cortex, primary somatosensory cortex, and posterior parietal cortex ascended through the posterior limb of the internal capsule. No significant difference in fractional anisotropy, mean diffusivity, and fiber volume of all reconstructed thalamocortical projections was observed between the right and left hemispheres (p>0.05). Conclusion: We reconstructed the thalamocortical projections between the intralaminar thalamic nuclei and the frontoparietal cortex in normal subjects. We believe that our findings would be useful to clinicians involved in the care of patients with impaired consciousness and for researchers in studies of the ARAS.

개 난자의 체외성숙중 핵변화 (Nuclear Changes Occurring During Cannine Oocyte Maturation In Vitro)

  • 김수조;박성은;이상호
    • 한국가축번식학회지
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    • 제17권3호
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    • pp.249-255
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    • 1993
  • Canine follicular oocytes were used to establish a reliable system for maturation and fertilization in vitro. Ovaries were obtained from either slaughter house or hormone-primed bitches of mixed breeds. The oocytes were recovered by mincing the ovaries in M2+BSA. Good quality of oocyte-cumulus complexes (OCCs) were selected and cultured in TCM 199 containing 15% fetal calf serum(FCS) for 24~56 h in an atmosphere of 5% CO2 at 39$^{\circ}C$. Maturation rate of follicular oocytes was >87% showing metaphase I. Unlike other domestic animals the cumulus expansion did not occur fully in canine OCCs although minimum expansion was found between the cumulus cells and corona radiata cells, the clear nuclear morphology was presented for the first time by rapid staining. The IVM system used in this study may be useful to obtain fully maturated metaphase I oocyte in dog.

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Injury of the Arcuate Fasciculus in the Nondominant Hemisphere by Subfalcine Herniation in Patients with Intracerebral Hemorrhage : Two Case Reports and Literature Review

  • Jang, Sung Ho;Kim, Seong Ho;Chang, Min Cheol
    • Journal of Korean Neurosurgical Society
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    • 제59권3호
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    • pp.306-309
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    • 2016
  • Using diffusion tensor tractography (DTT), we demonstrated injury of the arcuate fasciculus (AF) in the nondominant hemisphere in two patients who showed subfalcine herniation after intracerebral hemorrhage (ICH) in the dominant hemisphere. Two patients (patient 1 and patient 2) with ICH and six age-matched control patients who have ICH on the left corona radiata and basal ganglia without subfalcine herniation were recruited for this study. DTT was performed at one month after onset in patient 1 and patient 2. AFs of both hemispheres in both patients were disrupted between Wernicke's and Broca's areas. The fractional anisotropy value and tract numbers of the right AFs in both patients were found to be more than two standard deviations lower than those of control patients. In contrast, the apparent diffusion coefficient value was more than two standard deviations higher than those of control patients. Using the configuration and parameters of DTT, we confirmed injury of the AF in the nondominant hemisphere in two patients with subfalcine herniation following ICH in the dominant hemisphere. Therefore, DTT would be a useful tool for detection of underlying injury of the AF in the nondominant hemisphere in patients with subfalcine herniation.

발성실행증 사례연구 (Apraxia of Phonation: a Case Report)

  • 권미선;나덕렬;김향희;정진상
    • 음성과학
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    • 제12권2호
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    • pp.101-108
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    • 2005
  • Apraxia of phonation (AOP) has often been described as a feature of apraxia of speech or of severe non-fluent type of aphasia. Pure AOP is rare and, to our knowledge, only two cases have been reported. Brain lesion sites of the reported cases were not those sites known to be responsible for apraxia of speech. This study presents a case of AOP which resulted from the secondary stroke in the left corona radiata immediately following the first stroke in the left temporoparietal lobe. A 61-year old right-handed man shwoed a global type of aphasia after the first cerebral infarction, but was able to generate spontaneously some short fragments of speech. On the day after the first infarction, he suffered from the secondary infarction, leaving him a complete loss of voluntary phonation. He did not showed any significant change in language functions. Several occurrences of involuntary phonation were observed upon laughing or crying. He was also able to cough unintentionally. A vidoe-stroboscopic examination failed to reveal any evidence of structural and functional impairment in larynx. Although this case is not of pure form of AOP, AOP appeared after the secondary stroke without significant changes of language impairment since the first stroke. Therefore, AOP may be a consequence of the brain lesion from the secondary stroke even though we cannot rule out the possibility of an additive effect of the secondary to the first stroke.

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The Approach of Robot-assisted Gait Therapy for Locomotor Recovery of Chronic Stroke Patients: a Case Report

  • Shin, Hee-Joon;Lee, Ju-Hyeok;Seo, Dong-Kyu;Kim, Hong-Rae;Moon, Ok-Kon;Park, Si-Eun;Park, Joo-Hyun;Kim, Nyeon-Jun;Min, Kyung-Ok
    • 국제물리치료학회지
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    • 제2권1호
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    • pp.207-213
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    • 2011
  • In this case report, we investigated the effects of robot-assisted gait therapy in a chronic stroke patient using motor assessment and gait analysis. A patient who suffered from the right hemiparesis following the left corona radiata and basal ganglia infarction received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks. Outcome was measured using Motoricity index(MI), Fugl-Meyer assessment(FMA), modified motor assessment scale(MMAS), isometric torque, body tissue composition, 10-meter gait speed and gait analysis. After robot-assisted gait therapy, the patient showed improvement in motor functions measured by MI, FMA, MMAS, isometric torque, skeletal muscle mass, 10-meter gait speed. In gait analysis, cadence, single support time, double support time, step length, walking speed improvement in after robot-assisted gait therapy. The results of this study showed that robot-assisted gait therapy is considered to facilitate locomotor recovery of the chronic hemiparetic stroke patient.