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A Case of Subcortical Dementia After Cerebral Malaria (말라리아 후유증으로 초래된 피질하성 치매 1례)

  • Chung, Hyo-Kyung;Lee, Young-Ho;Chung, Young-Cho;Kim, Su-Sie;Park, Byoung-Kwan
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.301-305
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    • 1995
  • Subcortical dementia may occur as a complication of cerebral malaria via deep white matter demyelination with encephalitis and diffuse small vessel vasculitis. In subcortical dementia, impairment in attention and frontal executive function are predominant. Patients are often inert, indifferent, and uninterested. They appear characteristically 'slowed up' with a marked deficit in the retrieval of information. Changes in mood, personality, and social conduct are very common. We describe a case of subcortical dementia, who has definite changes in brain MRI after cerebral malaria.

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A Review of Studies of Tongue Deviations in Korean Stroke Patients (국내 중풍 환자의 설진에 관한 연구 고찰)

  • Park, Young-hwa;Lim, Bo-ra;Cho, Jun-ho;Won, Jeong-yoon;Kwon, Do-ick
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.152-163
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    • 2017
  • Objectives: The aim of this review was to compare the findings of 14 studies of tongue diagnosis in Korean stroke patients. Methods: The purpose, subjects, observation methods, statistical methods, classification of tongue diagnosis, significance, and limitations were analyzed and compared. Results: In Korean stroke patients, tongue diagnosis is significant in pattern identifications, prognosis evaluation, degree of neurological deficit, past history, blood tests, and pulse diagnosis. Interobserver reliability of tongue diagnosis is relatively high.

Remote Cerebellar Hemorrhage after Intradural Disc Surgery

  • Yoo, Je Chul;Choi, Jeong Jae;Lee, Dong Woo;Lee, Sangpyung
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.118-120
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    • 2013
  • We report a rare case of remote cerebellar hemorrhage after intradural disc surgery at the L1-2 level. Two days after the spine surgery, patient complained unexpected headache, dizziness, nausea and vomiting. From the urgently conducted brain CT, it was reported that the patient had cerebellar hemorrhage. Occipital craniotomy and hematoma evacuation was performed, and hemorrhagic lesion on the right cerebellum was effectively removed. After occipital craniotomy, the patient showed signs of improvement on headache, dizziness, nausea and vomiting. He was able to leave the hospital after two weeks of initial operation without any neurological deficit. Remote cerebellar hemorrhage following spinal surgery is extremely rare, but may occur from dural damage of spinal surgery, accompanied with cerebrospinal fluid leakage. Early diagnosis is particularly important for the optimal treatment of remote cerebellar hemorrhage.

Three Case Reports of Urinary Disturbance as Heat Syndrome Treated with Jasin-hwan (열증으로 변증된 배뇨곤란 환자의 자신환 치험 3례)

  • Kim, Tae-Yong;Oh, Min-Kyu;Shin, Hyeon-Su;Han, Jong-Hyun;Park, Jun-Beom
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.927-935
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    • 2006
  • Urinary disturbance is deficit in volitional control of voiding. Stroke can cause temporary or permanent urinary disturbance. The purpose of this study was to confirm the effect of Jasin-hwan on urinary disturbance as heat syndrome. This study was carried out on 3 patients with urinary disturbance caused by stroke. We measured components of IPSS (international prostate symptom score) at pre-treatment and post-treatment. After prescribing medication to the patients, symptoms improved rapidly within three weeks. These results support that Jasin-hwan is effective in reduction of urinary disturbance as heat syndrome.

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The Relationship between Hair Zinc and Lead Levels and Clinical Features of Attention-Deficit Hyperactivity Disorder

  • Shin, Dong-Won;Kim, Eun-Ji;Oh, Kang-Seob;Shin, Young-Chul;Lim, Se-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.25 no.1
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    • pp.28-36
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    • 2014
  • Objectives : The goal of this study was to examine the association between zinc and lead level and symptoms of attention-deficit hyperactivity disorder (ADHD) among Korean children. Methods : A total of 89 clinic-referred children participated in the study (ADHD group=45, control group=44). The participants were 5-15 years old, and were mainly from urban areas of Seoul, Korea. ADHD was diagnosed using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. We excluded children with a comorbid psychiatric disorder, medical illness requiring medication, or a prior history of taking ADHD medication. In order to evaluate the severity of ADHD symptoms, parents' Korean ADHD Rating Scale (K-ARS) was used. The ADHD diagnostic system (ADS) was used for evaluation of the severity of inattention and impulsivity. All participants completed the intelligence test and hair mineral analysis. Multiple regression analysis was used to examine the effect of hair zinc and lead levels on the K-ARS and ADS. We measured the predictive ability of the zinc and lead levels using logistic regression analysis. Results : The lead level explained the score for omission errors, commission errors, and response time SD in visual ADS in the ADHD group (adjusted $R^2$=.243, p<.01, adjusted $R^2$=.362, p<.01, and adjusted $R^2$=.275, p<.01), the score for omission errors of auditory ADS in ADHD group (adjusted $R^2$=.407, p<.01) and the entire group (adjusted $R^2$=.292, p<.01). Zinc was significantly explanatory for the K-ARS scores for the entire group (adjusted $R^2$=.248, p<.001) and the ADHD group (adjusted $R^2$=.247, p<.05). Conclusion : These findings suggest a possible role of zinc and lead in ADHD. Lead concentration in hair samples affected the ADS scores, and this was more prominent in children with ADHD. Children with ADHD had a lower zinc concentration in their hair, and the zinc concentration in hair showed negative correlation with the K-ARS score.

Development of the Korean Practice Parameter for Adult Attention-Deficit/Hyperactivity Disorder

  • Bahn, Geon Ho;Lee, Young Sik;Yoo, Hanik K.;Kim, Eui-Jung;Park, Subin;Han, Doug Hyun;Hong, Minha;Kim, Bongseog;Lee, Soyoung Irene;Bhang, Soo Young;Lee, Seung Yup;Hong, Jin Pyo;Joung, Yoo-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.1
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    • pp.5-25
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    • 2020
  • Objectives: Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. Methods: The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. Results: According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners' Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. Conclusion: The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

Change of Quality of Life in Children with ADHD after 12 Weeks OROS-Methylphenidate Treatment (12주 OROS-Methylphenidate 약물 치료 후 ADHD 아동의 삶의 질 변화)

  • Kim, Hyung-In;Kim, Bung-Nyun;Cho, Soo-Churl;Shin, Min-Sup;Yoo, Hee-Jeong;Kim, Jae-Won;Kim, Ji-Hoon;Son, Jung-Woo;Shin, Yun-Mi;Chung, Un-Sun;Han, Doug-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.3
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    • pp.103-108
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    • 2012
  • Objectives : The aim of this study is to investigate the effectiveness of treatment with osmotic-release oral system methylphenidate (OROS-MPH) on quality of life (QOL) in children with attention-deficit hyperactivity disorder (ADHD). Another aim is to assess the relationship between change in QOL and other factors including children's symptoms and academic performance or parents' depression and parenting stress. Methods : A total of 111 medication-naive children with ADHD in a multicenter, open-label, 12-week trial of OROS-MPH completed an evaluation using diverse rating scales at two time points; at baseline and after 12 weeks of treatment. Scales for investigation of children included the Parent Report Form-Children's Health and Illness Profile-Children's Edition (PRF-CHIP-CE) on QOL, the ADHD Rating Scale-IV on symptoms, and the Academic Performance Rating Scale (APRS). The Beck Depression Inventory and Parenting Stress Index were used for assessment of their parents. Results : Total scores for mean PRF-CHIP-CE increased from $207.9{\pm}26.7$ at baseline to $226.3{\pm}25.9$ after 12 weeks of treatment (p<.001). The change of APRS showed the strongest correlation with the increment of PRF-CHIP-CE scores (Pearson coefficient=0.561, p<.001), even after controlling for other factors (partial correlation coefficient=0.420, p<.001). Conclusion : Treatment with MPH-OROS results in improvement of QOL in children with ADHD in Korea. The advance in academic performance plays a key role in this change of QOL.

Atypical Choroid Plexus Papilloma in an Adult

  • Lee, Sung-Ho;Park, Bong-Jin;Kim, Eui-Jong;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.74-76
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    • 2009
  • We present an extremely rare case of the atypical choroid plexus papilloma in an adult which developed at the trigone of right lateral ventricle. A 62-year-old woman presented with the history of intermittent and gradually progressive headache and left side hemiparesis for 6 months. The brain magnetic resonance image showed highly enhanced and well demarcated mass at the trigone of lateral ventricle attached to the choroid plexus. Gross total resection was performed by transcortical approach via the middle temporal gyrus. The tumor was diagnosed as an atypical choroid plexus papilloma. She had no neurologic deficit after the surgery. We report a case of atypical choroid plexus papilloma in adult and introduce newly classified pathologic characteristics of this tumor.

Diagnostic Usefulness of High Resolution Cross Sectional MRI in Symptomatic Middle Cerabral Arterial Dissection

  • Lee, Hai-Ong;Kwak, Hyo-Sung;Chung, Gyung-Ho;Hwang, Seung-Bae
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.370-372
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    • 2011
  • Dissection of the middle cerebral artery (MCA) is less frequent compared with dissection of the vertebrobasilar system or carotid artery. Recently, high-resolution cross sectional MR imaging (HRMRI) has emerged as a potential technique for atherosclerotic plaque imaging in MCA, We introduce the findings of HRMRI in a 56-year-old woman with traumatic MCA dissection, HRMRI showed an intimal flap and tapered pseudolumen with intra-luminal hemorrhage, We performed stent deployment about MCA dissection after failed medical treatment Three months later, there was no in-stent restenosis and no further neurological deficit were noted.

Craniovertebral Junction Tuberculosis with Atlantoaxial Dislocation : A Case Report and Review of the Literature

  • Lee, Dae-Kyu;Cho, Keun-Tae;Im, So-Hyang;Hong, Seung-Koan
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.406-409
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    • 2007
  • Craniovertebral junction (CVJ) tuberculosis is a rare disease, potentially causing severe instability and neurological deficits. The authors present a case of CVJ tuberculosis with atlantoaxial dislocation and retropharyngeal abscess in a 28-year-old man with neck pain and quadriparesis. Radiological evaluations showed a widespread extradural lesion around the clivus, C1, and C2. Two stage operations with transoral decompression and posterior occipitocervical fusion were performed. The pathological findings confirmed the diagnosis of tuberculosis. Treatment options in CVJ tuberculosis are controversial without well-defined guidelines. But radical operation (anterior decompression and posterior fusion and fixation) is necessary in patient with neurological deficit due to cord compression, extensive bone destruction, and instability or dislocation. The diagnosis and treatment options are discussed.