• Title/Summary/Keyword: ICH

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Coil Embolization of Aneurysm Followed by Stereotactic Aspiration of Hematoma in a Patient with Anterior Communicating Artery Aneurysm Presenting with SAH and ICH

  • Kim, Sung-Ho;Yoon, Seok-Mann;Shim, Jai-Joon;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.41-44
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    • 2008
  • Even though intracerebral hematoma (ICH) due to ruptured cerebral aneurysm has been treated by aneurysm clipping at the same time of removal of ICH through craniotomy, such management strategy is controversial in an aged patients with poor clinical grade. In this regards, stereotactic aspiration of hematoma following coil embolization can be an alternative treatment modality. Thus, the authors report a case of an aged patient who underwent stereotactic aspiration of ICH following coil embolization for the ruptured aneurysm with a brief review of literature.

Die Analysen von Diskursstrukturen anhand einer neuen Diskursgrammatik (담화의 구조 - 새로운 담화문법의 설계)

  • Lee Hae-Yun
    • Koreanishche Zeitschrift fur Deutsche Sprachwissenschaft
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    • v.4
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    • pp.109-128
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    • 2001
  • Bei vorliegender Arbeit wurde eine sogenannte Diskursstrukturgrammatik (DSG) vorgestellt, die auf die $Erkl\"{a}rung$ von verschiedenen diskursbezogenen $Ph\"{a}nomenen$ zielt, und derer Grundlage auf 'Head-driven Phrase Structure Grammar (HPSG)' basiert. Im Abschnitt 2 wurde die Syntax von DSG gegeben. Die Syntax besteht aus Grundsymbolen und Regeln. Die Grundsymbole teilen sich wiederum in grundlegende Diskurseinheiten und logische Konnektoren ein. Entsprechend der Syntax wurde die Semantik im Abschnitt 3 gegeben. Insbesondere habe ich das Diskursrelation­Prinzip aufgestellt, nach dem die Information eines Konnektoren die Bedeutung der neu gebildeten Diskurseinheit bestimmt. Im letzten Abschnitt 4 habe ich anhand der DSG zwei Beispiele analysiert, um zu zeigen, wie die DSG funktioniert. Von der Theorie aus gesehen, ist die vorgestellte DSG nicht $vollst\"{a}ndig$. Deshalb werde ich weiter die DSG systematisieren, indem ich andere $Ph\"{a}nomene$ im Bereich des Diskurses wie Anapher, Tempus usw. behandle

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Comparison of the Effects of Familiar Exercise and Novel Exercise on the Motor Function in Rat of Intracerebral Hemorrhage (익숙한 운동과 새로운 운동이 뇌내 출혈 흰쥐의 운동기능에 미치는 효과 비교)

  • Jang, Sang-Hun;Hwang, Kyoung-Ok;Kim, Jin-Sang
    • Physical Therapy Korea
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    • v.19 no.3
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    • pp.72-80
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    • 2012
  • The purpose of the present study was to investigate the effects of familiar exercise and novel exercise on motor function after intracerebral hemorrhage (ICH) in rats. The rats were subjected to a unilateral striatal ICH via collagenase infusion. The rats were randomly divided into the following three groups: the CON (control group; rested one week post-ICH), the FE (familiar exercise group; familiar exercise was performed two weeks after one-week post-ICH period), and NE (novel exercise group; novel exercise was performed two weeks after one-week post-ICH period). We measured neurological behavior using a ladder rung walking test and a beam walking test; we measured the level of nerve growth factor (NGF) using immunohistochemistry and western blot analysis. We performed a one-way ANOVA test to analyze the scores obtained from the neurological behavior tests and the differences of NGF protein levels among the three groups. In the present study, the FE group and the NE group showed significant improvement during the neurological behavior tests and in their expression of NGF protein level, as compared to the CON group. Especially, NE group more increase than FE group in neurological behavior tests, the expression of NGF on motor cortex. In conclusion, these results suggest that, after ICH, familiar exercise and novel exercise enhance motor function and, novel exercise is more effective than familiar exercise.

Effects of Gastrodiae Rhizoma on Brain Edema and Aquaporin Expressions Following Intracerebral Hemorrhage in Rats (천마(天麻)가 뇌조직출혈(腦組織出血) 흰쥐의 뇌부종(腦浮腫)과 Aquaporins 발현에 미치는 영향)

  • Lee, Ju-Yong;Ku, Ja-Seung;Lee, Dong-Eun;Shin, Jung-Won;Kim, Seung-Joon;Sohn, Nak-Won
    • The Korea Journal of Herbology
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    • v.25 no.4
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    • pp.85-93
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    • 2010
  • Objectives : This study aimed at evaluation of the effects of Gastrodiae Rhizoma on brain edema and aquaporin water channel expressions in the brain. Methods : Brain edema following intracerebral hemorrhage (ICH) was induced by the stereotaxic intrastriatal injection of bacterial collagenase type VII in Sprague-Dawley rats. Then ethanol extract of Gastrodiae rhizoma was treated once a day for 3 days. Brain edema % and water contents, and cell size of neurons in the cerebral cortex were examined. Immuno-histochemistry was processed for AQP4, AQP1, and AQP9 expressions in the brain sections and area % of immuno-labeling was analyzed with image analysis. Results : 1. Ethanol extract of Gastrodiae Rhizoma reduced brain edema of ICH induced rats significantly. 2. Ethanol extract of Gastrodiae Rhizoma reduced excessive brain tissue water contents of ICH induced rats significantly. 3. Ethanol extract of Gastrodiae Rhizoma reduced cellular edema of neurons in cerebral cortex of ICH induced rats significantly. 4. Ethanol extract of Gastrodiae Rhizoma reduced AQP4 immuno-positive area % in cerebral cortex and external capsule of ICH induced rat brain significantly. 5. Ethanol extract of Gastrodiae Rhizoma reduced AQP9 immuno-positive area % in glia limitans externa of ICH induced rat brain significantly. Conclusions : These results suggest that Gastrodiae Rhizoma reveals protective effects against brain edema and cytotoxic edema of neurons by means of down-regulation of AQP4 expression in the brain.

Seizures after Spontaneous Intracerebral Hemorrhage

  • Woo, Kwang-Moo;Yang, Seung-Yeob;Cho, Keun-Tae
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.312-319
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    • 2012
  • Objective : In patients with spontaneous intracerebral hemorrhage (ICH), the risk factors for seizure and the effect of prophylactic anticonvulsants are not well known. This study aimed to determine the risk factor for seizures and the role for prophylactic anticonvulsants after spontaneous ICH. Methods : Between 2005 and 2010, 263 consecutive patients with spontaneous ICH were retrospectively assessed with a mean follow-up of 19.5 months using medical records, updated clinical information and, when necessary, direct patient contact. The seizures were classified as early (within 1 week of ICH) or late (more than 1 week after ICH). The outcomes were measured with the Glasgow Outcome Scale at discharge and the modified Rankin Scale (mRS) at both 2 weeks and discharge. Results : Twenty-two patients (8.4%; 9 patients with early seizures and 13 patients with late seizures) developed seizures after spontaneous ICH. Out of 263 patients, prophylactic anticonvulsants were administered in 216 patients. The prophylactic anticonvulsants were not associated with a reduced risk of early (p=0.094) or late seizures (p=0.326). Instead, the factors associated with early seizure were cortical involvement (p<0.001) and younger age (60 years or less) (p=0.046). The risk of late seizure was increased by cortical involvement (p<0.001) and communicating hydrocephalus (p=0.004). The prophylactic anticonvulsants were associated with a worse mRS at 2 weeks (p=0.024) and at last follow-up (p=0.034). Conclusion : Cortical involvement may be a factor for provoked seizures. Although the incidence of early seizures tended to decrease in patients prescribed prophylactic anticonvulsants, no statistical difference was found.

Comparison for Hepatitis B Knowledge, Self Care Practice and Quality of Life according to the Disease Activity among Patients with the Hepatitis B Virus (B형간염 바이러스 보유 환자의 질환 활성도에 따른 B형간염 지식, 자가간호수행 및 삶의 질 비교)

  • Seo, Im Sun;Song, Myeong Jun;Yoo, Yang-Sook;Kim, Hyoung Suk
    • Journal of Korean Public Health Nursing
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    • v.31 no.2
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    • pp.257-271
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    • 2017
  • Purpose: The hepatitis B virus is a major cause of chronic liver disease. The clinical guidelines recommend that inactive chronic hepatitis (ICH) patients also check their liver function every 6 to 12 months and manage the potential risks. This study compared the hepatitis B knowledge, self-care practice, and quality of life in patients with HBV according to the disease activity. Methods: This study was conducted in a university hospital and surveyed on 65 ICH patients and 68 progressive chronic liver disease (PCLD) patients from November in 2012 to September in 2013. Results: The knowledge of hepatitis B was lower in the group of a lately perceived HBV infection and ICH. Self-care practice was lower in the male and the patients group with a perceived HBV infection within 5 years. The "taking regular liver function test" score was lower in the ICH. Eight out of 12 Liver Disease Quality of Life instrument (LDQOL) subscales were lower in PCLD. Conclusion: The hepatitis B knowledge and self-care practice are relatively lacking in ICH and the patients group with a perceived HBV infection within 5 years. More effective education programs will be necessary to enhance the hepatitis B knowledge and self-care for patients with HBV and even for ICH.

Role of 'Spot Sign' on CT Angiography to Predict Hematoma Expansion in Spontaneous Intracerebral Hemorrhage

  • Park, Soo-Yong;Kong, Min-Ho;Kim, Jung-Hee;Kang, Dong-Soo;Song, Kwan-Young;Huh, Seung-Kon
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.399-405
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    • 2010
  • Objective : Patients with spontaneous intracerebral hemorrhage (ICH) presenting within 24 hours of symptom onset are known to be increased risk of hematoma expansion which is closely correlated with morbidity and mortality. We investigated whether tiny enhancing foci ('Spot sign') on axial view of 3-dimensional computed tomography angiography (3D-CTA) source images can predict subsequent hematoma expansion in spontaneous ICH. Methods : During a 2-year period (March 2007-March 2009), we prospectively evaluated 3D-CTA of 110 patients with spontaneous ICH. Based on source images of 3D-CTA, patients were classified according to presence or absence of 'Spot sign'; 'Spot sign' (+) group, 'Spot sign' (-) group. Radiological factors and clinical outcomes were compared between two groups. Results : Hematoma expansion occurred in 16 patients (15%). Mean Glasgow Coma Scale (GCS) score of patients with hematoma expansion was significantly different compared to score of patients without hematoma expansion (5 vs. 9, P < 0.001). Nineteen patients (16%) of 110 ICH patients demonstrated 'spot sign' on 3D-CTA. Among the 'spot sign' (+) group, 53% of patients developed hematoma expansion. Conversely 7% of patients without 'spot sign' demonstrated the hematoma expansion (p < 0.001). Initial volume and location of hematoma were significantly not associated with hematoma expansion except shape of hematoma. Conclusion : Our study showed that patients with hematoma expansion of spontaneous ICH had significant clinical deterioration. And the fact that 'spot sign' (+) group have higher risk of hematoma expansion suggests the presence of 'spot sign' on source images of 3D-CTA can give a clue to predict hematoma expansion in spontaneous ICH.

Growth Factor According to Rebleeding in Small Volume Spontaneous Intracerebral Hemorrhage (소량의 자발성 뇌내출혈에서 재출혈에 의한 혈종 성장에 미치는 인자)

  • Jung, Hyun Ho;Kim, Sei Yoon;Whang, Kum;Cho, Sung Min;Pyen, Jhin Soo;Hu, Chul;Hong, Soon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.259-265
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    • 2001
  • Objectives : Spontaneous intracerebral hemorrhage(S-ICH) is generally considered to be a mon-ophasic event. But some patients with ICH continued to bleed even after hospitalization. In order to evaluate the rebleeding and growth factor of hematoma in small volume S-ICH, 125 cases of S-ICH were reviewed retrospectively. Methods : We assesed age, sex, initial mental state, location of hemorrhage, systolic and diastolic blood pressure, blood pressure patterns, hematologic profile, trauma and stroke history, alcohol consumption and smoking history. Two subgroups-rebleeding groups versus no rebleeding groups-were compared, in terms of data analysis, with student T-test and chi-square test. Results : Substantial growth in the volume of S-ICH occurred in 21 cases(16.8%)-putamen(7 cases), thalamus(6 cases), subcortex(5 cases), cerebellum(2 cases), pons(1 case)-of the 125 patients. There was no significant difference in any of the parameters except initial systolic blood pressure(p=0.037) when patients with and without rebleeding were compared. Conclusion : The rebleeding and growth of the small volume S-ICH was related to the markedly elevated initial systolic blood pressure(${\geq}180mmHg$) and labile pattern of blood pressure.

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Surgery versus Conservative Treatment for Spontaneous Supratentorial Intracerebral Hemorrhage in Spot Sign Positive Patients

  • Kim, Hui-Tae;Lee, Jong-Myong;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.58 no.4
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    • pp.309-315
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    • 2015
  • Objective : An advantage of surgical treatment over conservative treatment of spontaneous intracerebral hemorrhage (ICH) is controversial. Recent reports suggest that contrast extravasations on CT angiography (CTA) might serve as a crucial predictor of hematoma expansion and mortality. The purpose of this study was aimed at investigating the efficacy of surgical treatment in patients with spot sign positive ICH. Methods : We used our institutional medical data search system to identify all adult patients who admitted for treatment of ICH between January 1, 2007 and January 31, 2012. Patients were classified two groups into a surgical group (n=27) and a conservative treatment group (n=28). Admission criteria were the following: age 20-79 years, spontaneous supratentorial ICH, Glasgow Coma Score Ranging from 9 to 14, ICH volume ${\geq}20mL$, and treatment within 24 hours. Results : Fifty-five patients were analyzed. There was no significant difference in the ICU stay between the conservative treatment group ($7.36{\pm}3.66days$) and the surgical treatment group ($6.93{\pm}2.20days$; p=0.950). There was a significant difference in the in-hospital stay between the conservative treatment group ($13.93{\pm}8.87days$) and the surgical treatment group ($20.33{\pm}6.37days$; p=0.001). Overall mortality at day 90 after ICH was 36.4%; this included 16 of 28 patients (57.1%) in the conservative group and 4 of 27 patients (14.8%) in the surgical group. In univariate analysis, there was a positive effect of the surgical treatment in reducing mortality at 90 days (p=0.002), Glasgow Outcome Scale (GOS) at 90-day (p=0.006), and modified Rankin Scale (mRS) at 90-day (p=0.023). In multivariate logistic analysis, there was a significant difference in mortality (odds ratio, 0.211; 95% confidence interval, 0.049-0.906; p=0.036) between the groups at 90-day follow-up. However, there was no significant difference in GOS (odds ratio, 0.371; 95% confidence interval, 0.031-4.446; p=0.434) and mRS (odds ratio, 1.041; 95% confidence interval, 0.086-12.637; p=0.975) between the groups at 90-day follow-up. Conclusion : In this study of surgical treatment of supratentorial ICH in patients with spot sign positive in CTA was associated with less mortality despite of long duration of in-hospital stay. We failed to show that clinical outcome benefit of surgical treatment compared with conservative treatment in patients with spot sign positive ICH.

Effects of Rhodiola Rosea on Brain Edema and Matrix Metalloproteinase Expressions Following Intracerebral Hemorrhage in the Rat (홍경천(紅景天)이 뇌조직내출혈(腦組織內出血) 흰쥐의 뇌부종(腦浮腫)과 Matrix Metalloproteinase 발현에 미치는 영향)

  • Ryu, Sa-Hyun;Lee, Joon-Suk;Shin, Jung-Won;Kim, Seong-Joon;Sohn, Nak-Won
    • The Korea Journal of Herbology
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    • v.26 no.4
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    • pp.169-180
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    • 2011
  • Objectives : This study aimed at evaluation of the effects of Rhodiola rosea on brain edema and expressions of matrix metalloproteinases (MMPs) related to blood-brain barrier (BBB) disruption. Methods : Brain edema following intracerebral hemorrhage (ICH) was induced by the stereotaxic intrastriatal injection of bacterial collagenase type VII in rats (Sprague-Dawley). Then ethanol extract of Rhodiola rosea was treated once a day for 3 days. Brain edema % and water contents, and BBB leakage were examined. Immunohistochemistry was processed for MMP-9, MMP-12, and iNOS expressions in the brain sections and each immuno-labeled cells were analyzed with image analysis software. Results : 1. Ethanol extract of Rhodiola rosea reduced brain edema following ICH in rats significantly. 2. Ethanol extract of Rhodiola rosea reduced excessive brain tissue water contents following ICH in rats significantly. 3. Ethanol extract of Rhodiola rosea reduced BBB leakage in the cerebral cortex following ICH in rats. 4. Ethanol extract of Rhodiola rosea reduced cellular edema of neurons in peri-hematoma and the cerebral cortex following ICH in rats significantly. 5. Ethanol extract of Rhodiola rosea reduced MMP-9 positive cells in the cerebral cortex following ICH in rats significantly. 6. Ethanol extract of Rhodiola rosea reduced MMP-12 positive vessels in the cerebral cortex following ICH in rats significantly. 7. Ethanol extract of Rhodiola rosea reduced iNOS positive cells in the cerebral cortex and external capsule following ICH in rats significantly. Conclusions : These results suggest that Rhodiola rosea reveals protective effect against brain edema and cytotoxic edema of neurons by means of down-regulation of MMPs and iNOS expressions, and inhibition of BBB leakage.