• Journal of Korean Neurosurgical Society
• /
• v.54 no.2
• /
• pp.139-141
• /
• 2013

Presented here is a 36-year-old male with arterial hypertension who developed brainstem edema and intracranial hemorrhage. Magnetic resonance scan revealed diffuse brainstem hyperintensity in T2-weighted and fluid-attenuated inversion-recovery images, with an increase in apparent diffusion coefficient values. After a reduction in blood pressure, rapid resolution of the brainstem edema was observed on follow-up. The patient's condition was thus interpreted as hypertensive brainstem encephalopathy. While many consider this a vasogenic phenomenon, induced by sudden, severe hypertension, the precise mechanism remains unclear. Prompt recognition and aggressive antihypertensive treatment in such patients are essential to prevent permanent or life-threatening neurologic injury.

• Proceedings of the KSMRM Conference
• /
• 2002.11a
• /
• pp.84-84
• /
• 2002

목적： 야간성 전두협 발작 (Nocturnal frontal lobe epilepsy NFLE)은 임상적으로 특징적인 야간성 운동성 발작으로 잘 알려져 있지만 일반적인 MR 영상에서는 대부분에서는 특이한 소견을 보이지 않아 확산 텐서 영상 (DTI)에서의 이상 소견 발현 유무를 알아보고자 한다. 대상 및 방법： 임상적 소견과, EEG 소견으로 진단된 NFLE 환자 6명을 대상으로 DTI 영상을 촬영하였다. 남자 2명, 여자 4명으로 평균연령은 32세 이었다. DTI영상은 single shot spin echo EPI 펄스 열을 사용하였고 사용한 영상 변수는 b value는 0, 1000 s/$\textrm{mm}^2$, TR 10000 msec, TE 71.8/72.3 msec, matrix 128$\times$128 (256 reconstruction), FOV 23cm, 5mm thickness, 2mm interstice gap, NEX 1. 19 slices, time은 4min 21sec (25방향) 이었다. 대조군으로 정상 성인 10명 (평균연령 31세)에서 동일한 방법으로 DTI 영상을 시행하여 분할 비등방도 (fractional anisotropy) 영상을 얻고 전두엽 백질에서 분할 비등방도 값을 측정하여 NFLE 환자군과 비교하였다.

• Proceedings of the KSMRM Conference
• /
• 2002.11a
• /
• pp.83-83
• /
• 2002

목적： 현재 임상적으로 사용되고 있는 확산경사자장의 세기 이상( > 1200)의 강한 확산 경사자장이 가해진 경우 뇌구조물들의 확산계수값을 조사하고 고자장(Bo = 3T)에서 이러한 강한 확산 경사자장을 이용하는 경우 1.5T에서 시행하는 경우와의 차이점을 비교 연구해보고자 하였다. 대상 및 방법： 정상 성인 3명을 대상으로 b-value를 0부터 3500까지 변화시키며 확산강조영상을 최대경사자장 40 mT/m, slew rate 150 T/m/s의 경사자장계가 장착된 3T MR scanner (General Electric, USA)에서 획득하였다. 사용한 펄스열은 Stejskal-Tanner type의 확산강조 경사자장이 포함된 single-shot SE EPI를 사용하였으며 영상획득시 사용한 파라미터는 다음과 같다. TR/TE= 10000/95.1, Thickness/space=512mm, FOV=24$\times$21cm, Matrix=128$\times$128, NEX=1 뇌구조물들에 관심 영역을 설정하고 b-value에 따른 신호감소를 측정하였다. 측정된 데이터를 hi-exponential decay 모델을 이용하여 분석하였다.

• Journal of Chest Surgery
• /
• v.49 no.5
• /
• pp.392-396
• /
• 2016

We report a case of aortic dissection masquerading as acute ischemic stroke followed by intravenous thrombolysis. A 59-year-old man presented with dizziness. After examination, the patient had a seizure with bilateral Babinski signs. Soon after identifying multiple acute infarctions in both hemispheres on diffusion-weighted brain magnetic resonance (MR) imaging, tissue plasminogen activator (t-PA) was administered. Both common carotid arteries were invisible on MR angiography, and subsequent chest computed tomography revealed an aortic dissection. The emergency operation was delayed for 13 hours due to t-PA administration. The patient died of massive bleeding.

• Journal of Korean Neurosurgical Society
• /
• v.41 no.6
• /
• pp.411-413
• /
• 2007

We report on a diabetic 52-year-old man who complained ocular floating sensation, headache and dizziness, in whom a left parieto-occipital dural ateriovenous fistulas [DAVFs], fed by bilateral superficial temporal arteries and occipital artery, drained into the cortical vein of the left parieto-occipital convexity. Because the patient's chief complaint was ocular symptom for diabetic retinopathy, we initially didn't consider an DAVFs until brain magnetic resonance imaging [MRI] was done. Diffusion-weighted brain MRI revealed acute cerebral infarction and microhemorrhage in the lesion. Transarterial embolization with mixture of glue and lipiodol obliterated the DAVFs completely. Although the DAVFs fed by multi-arteries, the fistulous portion has been disappeared after embolization via an only left occipital artery Endovascular embolization of the fistula led to symptomatic improvement, except ocular discomfort.

• Proceedings of the KSMRM Conference
• /
• 2003.10a
• /
• pp.98-98
• /
• 2003

We will present various MR findings of hyperacute ischemic stroke with our own experiences in the management of the patients according to the findings. 대상 및 방법： A total of 441 patients were underwent 'acute stroke MR' imaging protocol between Mar. 2001 and Jun. 2003. The protocol included initial T2-weighted image (WI), diffusion WI (DWI, b=2000), time-of-flight (TOF) MR angiography (MRA), and pefusion WI(PWI), and follow-up T2WI, DWI, TOF MRA, and neck vessel contrast-enhanced MRA obtained three to five days after the insult. Among them, we retrospectively reviewed the MR findings and clinical courses of 193 patients with anterior circulation territorial infarction. Those ICA and MCA lesions were divided into six and five groups respectively according to the level and mechanism of the occlusion. PWI findings can be another factor in the management planning.

• Korean Journal of Radiology
• /
• v.21 no.11
• /
• pp.1199-1209
• /
• 2020

The glymphatic system hypothesis is a concept describing the clearance of waste products from the brain. The term "glymphatic system" combines the glial and lymphatic systems and is typically described as follows. The perivascular space functions as a conduit that drains cerebrospinal fluid (CSF) into the brain parenchyma. CSF guided to the perivascular space around the arteries enters the interstitium of brain tissue via aquaporin-4 water channels to clear waste proteins into the perivascular space around the veins before being drained from the brain. In this review, we introduce the glymphatic system hypothesis and its association with fluid dynamics, sleep, and disease. We also discuss imaging methods to evaluate the glymphatic system.

• Journal of Korean Foot and Ankle Society
• /
• v.28 no.1
• /
• pp.36-39
• /
• 2024

Lupus panniculitis is a rare disease that may present with similar clinical manifestations to an infection, such as cellulitis or abscess. This paper reports a case of a 25-year-old woman with systemic lupus erythematosus who underwent surgical intervention initially with the suspicion of an abscess but who was eventually diagnosed with lupus panniculitis. Despite the low incidence of lower leg involvement of panniculitis, clinicians should be aware of the possibility of an etiology other than infection when encountering patients with inflammatory diseases. Moreover, a skin biopsy and magnetic resonance imaging with a diffusion-weight image may be helpful.

• Journal of the Korean Society of Radiology
• /
• v.81 no.6
• /
• pp.1412-1423
• /
• 2020

Purpose Some patients with neonatal seizures show diffuse, symmetric diffusion-restricted lesions in the cerebral white matter. The aim of this study was to describe clinical and imaging findings of patients with neonatal seizures who had diffuse, symmetric diffusion-restricted lesions without any structural or metabolic etiology. Materials and Methods A total of 56 neonates aged less than 1 week underwent brain magnetic resonance imaging (MRI) for evaluation of seizures from November 2008 to February 2017. After excluding 43 patients, 13 patients showed diffuse white matter abnormality on diffusion-weighted imaging. Initial and follow-up clinical and MRI findings were analyzed retrospectively. Results All 13 patients were born at full term. Among the ten patients who underwent a stool test for viruses, six were positive for rotavirus and one for astrovirus. MRI revealed diffuse, symmetric diffusion-restricted lesions distributed along the cerebral white matter, thalami, and midbrain variably. Conclusion Diffuse, symmetric diffusion-restricted lesions involving the cerebral white matter can be seen in patients with neonatal seizures without any structural or metabolic etiology. Rotavirus is commonly but not exclusively detected in these patients. Nevertheless, viral infection-associated encephalopathy should be considered for patients with characteristic clinical and MRI findings.

• Investigative Magnetic Resonance Imaging
• /
• v.13 no.1
• /
• pp.54-62
• /
• 2009

Purpose : Craniospinal neurenteric (NE) cysts are rare developmental non-neoplastic cysts of the central nervous system with diverse MR imaging findings. The purpose of this study was to evaluate various MR imaging findings of intracranial and intraspinal NE cysts. Materials and Methods : We retrospectively reviewed the MR imaging findings of six NE cysts that were confirmed by pathology. We evaluated anatomic location, signal intensity, size and enhancement pattern of NE cysts. Results : Two intracranial lesions were located extra-axially in the cerebellopontine angle and quadrigeminal cisterns. Three spinal lesions were intraduralextramedullary cysts, located ventral to the spinal cord, but one thoracic lesion was an intramedullary cyst. The signal intensity of the cysts was hyperintense on T1-weighted images as compared with the cerebrospinal fluid (CSF) for two intracranial lesions and one cervical lesion. In addition, all intracranial lesions showed diffusion restriction. For the remaining three spinal lesions, the signal intensity was nearly the same as the signal intensity of the CSF as seen on both T1- and T2-weighted images. On contrast-enhanced studies, two intracranial cysts showed a small nodular enhancement and one thoracic spinal lesion showed rim enhancement. Conclusion : NE cysts have various locations, signal intensities, and possible focal nodular or rim enhancement. Therefore, NE cysts can be included in the differential diagnosis of various craniospinal cystic or tumorous cystic lesions.