• Korean Journal of Adult Nursing
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• v.13 no.1
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• pp.136-147
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• 2001

Dysphagia is common and serious problem in intracerebral hemorrhage patients. Nasogastric-tube intubation is an important method for dysphagic patients who have an intracerebral hemorrhage. But many discomforts develope in patients with a nasogastric-tube. Therefore, it is necessary to decide when to remove the tube and as early as possible. The purpose of this study is to decide the applying time of training program to facilitate deglution for dysphagic patients who have intracerebral hemorrhage. Among the 343 patients with intracerebral hemorrhage who had been admitted to P-university hospital from April, 1994 to December, 1998, the medical record of the 110 patients with nasogastric tube were reviewed retrospectively. Results from the study were as follows: 1. Nasogastric tube insert duration of improved patients was a mean of 23.2 days 2. When a L-tube was inserted and removed, the L.O.C. of improved patients was $2.6{\pm}0.8$(in the midst of stupor or a semicoma),$1.9{\pm}0.5$(close to drowsy), respectively. This was signifcantly different(P=0.000). 3. When a L-tube was inserted and removed, GCS of improved patients was $9.3{\pm}2.9$, $12.1{\pm}2.2$ respectively. This was significantly different (P=0.000). 4. The duration of nasogastric tube insertion was the longest when in a stupor(L.O.C), 6~8 points(GCS).

• Journal of Korean Medicine Rehabilitation
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• v.26 no.1
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• pp.1-11
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• 2016

Objectives The purpose of this study was to investigate the effect of Hyulboochucke-tang on the collagenase induced intracerebral hemorrhage in white rats. Methods To identify the effect of the Hyulboochucke-tang on intracerebral hemorrhage, intracerebral hemorrhage was induced in the right caudate nuclei of white rats. For normal group (n=12) and comparative group (n=12), saline was dosed, and vaccum evaporated Hyulboochucke-tang extract was dosed to treatment group (n=12), 3 and 10 days after the collagenase injection, the body weight, the brain weight, the size of hematoma, the size of the area of malacia, the number of apoptotic cell and the change in pathological histology were observed. Results 3 days after the injection, the brain weight(g) was considerably decreased in treatment group (n=12) compared to comparative group (n=12). The brain weight after 10 days of the injection was also considerably decreased in treatment group (n=6) against comparative group (n=6). The cross section(mm) of cerebral malacia after 10 days of the injection was considerably decreased in treatment group (n=6) compared to comparative group (n=6). The number of apoptotic cell in normal intracerebral around the area of malacia did not show considerable change between treatment group and comparative group. 12 days after the injection, the multiplication of gitter cells, astrocyte and newly formed capillaries around the area of malacia was distinct. Conclusions On the basis of these results, We sugggest that Hyulboochucke-tang controls swelling caused by hemorrhage and contributes to absorption of hematoma by multiplication of newly formed capillaries and recovery of damaged cerebral tissue by multiplication of gitter cells and astrocyte.

• Journal of Korean Neurosurgical Society
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• v.47 no.3
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• pp.210-212
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• 2010

Sildenafil citrate ($Viagra^{(R)}$ Pfeizer US Pharmaceutical Group, New York, NY, USA) is a potent vasodilating agent to treat male erectile dysfunction. Among its adverse effects, hemorrhagic stroke has not been widely reported yet. We present a case of a 33-year-old healthy man who ingested 50 mg sildenafil a half hour before onset of headache, nervousness and speech disturbance. Head computed tomogram of this stuporous man showed huge intracerebral hemorrhage and thick subarachnoid hemorrhage, but angiography failed to disclose any vascular anomalies. Subsequent surgical procedure was followed, and rehabilitation was provided thereafter. Sildenafil seems to act by redistributing arterial blood flow, and concurrent sympathetic hyperactivity, which lead to such hemorrhagic presentation. Extreme caution should be paid on even in a young adult male patient wven without known risk factors.

• Journal of Korean Neurosurgical Society
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• v.44 no.6
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• pp.405-408
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• 2008

GBM is the most common primary brain tumor, but intraventricular GBM is rare and only few cases have been reported in the literature. The authors report a case of 64-year-old man who had a remote history of previous periventricular intracerebral hemorrhage. Brain computed tomography (CT) and magnetic resonance (MR) imaging showed an intraventricular lesion with inhomogeneous enhancement, infiltrative borders and necrotic cyst, and obstructive hydrocephalus. The patient underwent surgical removal through transcortical route via the bottom of previous hemorrhage site and the final pathologic diagnosis was GBM. We present a rare case of an intraventricular GBM with detailed clinical course, radiological findings, and pathological findings, and the possible origin of this lesion is discussed.

• Journal of Korean Neurosurgical Society
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• v.30 no.2
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• pp.207-210
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• 2001

Objective : The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. Material and Method : A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. Results : In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. Conclusion : It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.87-100
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• 1997

Clinical Observation was made on 29 cases of Hypertensive intracerebral hemorrhage patients in the ICU of In-Chon Oriental Medical Hosptital of Dongguk University from October in 1994 to June in 1996. The observation are ability in daily life(ADL) of patients by Location and Type of Hemorrhage, Amounts of Hematoma, Graeb's Score, Intraventricular Hemorrhage, States 4th Ventricle, Surrounding Edema around the Hematoma, Middle Line Shift, Age, Level of Consciousness. Pupillary Light Reflex and Treatment Modalities. Our conclusions on Prognostic Factors using Computerized Tomographic Findings and Ability in daily Life(ADL) Evaluation in patients with Hypertensive Intracerebral Hemorrhage Patients are as follows. A variety of prognostic factors that influence ADL5+6(%) were observed. 1. ADL5+6($\%$) of total cases was 34.9%. The prognosis were unfavorable when high Graeb score(P<0.05), dilated 4th ventricle(P<0.01), much surrounding edema around the hematoma (P<0.05), unilateral unreactive or both unreactive pupillary light reflex(P<0.05). 2. There was no difference of ADL5+6(%) in both hypertensive basal ganglionic and thalamic intracerebral hemorrhage. 3. The prognosis gets poorer as the volume of hematoma is more than 16cc. But there was no difference of ADL5+6(%) in each group. 4. The prognosis gets poorer in cases with IVH than without IVH. But there was no difference of ADL5+6(%) in each group. 5. The prognosis gets poorer as the middle line shift is more than 6mm. But there was no. difference of ADL5+6(%) in each group. 6. The prognosis gets poorer as the level of consciousness is more than drowsy. But there' was no difference of ADL5+6(%) in each group.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.872-882
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• 2021

Objective: This study examined the effectiveness of Pyung-Hyung acupuncture and herbal medicine for a hemiplegic patient diagnosed with intracerebral hemorrhage. Methods: The patient was treated with Pyung-Hyung acupuncture and herbal medicine for one month. Intracerebral hemorrhage symptoms were evaluated using the Korean version of the Modified Barthel Index (K-MBI), the Manual Muscle Test (MMT), and brain CT images. Results: Following Pyung-Hyung acupuncture and herbal medicine, K-MBI, MMT, and brain CT image results improved. Conclusion: This case showed that Pyung-Hyung acupuncture and herbal medicine effectively treated intracerebral hemorrhage with hemiplegia.

• The Journal of the Society of Stroke on Korean Medicine
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• v.15 no.1
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• pp.106-115
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• 2014

■ Objectives The purpose of this case study is to report that a hypertension with intracerebral hemorrhage of tae-eumin was treated with 'Cheongsim Yeunja-tang' and then the symptoms were improved and blood pressure was decreased. ■ Methods Although the patient who had hypertension with intracerebral hemorrhage took antihypertension drugs, intermittent increase of blood pressure was shown. We diagnosed him as Tae-eumin and treated with Cheongsim Yeunja-tang. We daily checked blood pressure and evaluated the symptoms. ■ Results After the treatment with Cheongsim Yeunja-tang, blood pressure was decreased and symptoms were improved. ■ Conclusion The result shows Cheongsim Yeunja-tang has antihypertensive effect and improve hypertension symptoms of Tae-eumin patient with intracerebral hemorrhage.

• Investigative Magnetic Resonance Imaging
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• v.3 no.2
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• pp.167-172
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• 1999

Purpose : To evaluate the detection rate of hyperacute intracerebral hemorrhage in echo planar imaging (EPI) and other MR sequences. materials and Methods : Intracerebral hemorrhage was experimentally induced in ten rats. EPI, fast spin-echo (FSE) T2 weighted images, fluid attenuated inversion recovery (FLAIR), spin-echo (SE) T1 weighted images and gradient echo (GE) T1 weight ed images of rat's brains were obtained 2 hours after onset of intracerebral hemorrhage. EPI and FSE T2 images were additionally obtained 30 min and 1 hour after onset of hemorrhage in 3 and 6 rat, repeatedly, For objective visual assessment, discrimination between the lesion and normal brain parenchyma was evaluated on various MR sequences by three radiologists. For quantitative assessment, contrast-to-noise ratio (CNR) was calculated fro hemorrhage-normal brain parenchyma. Statistical analysis was performed usning the Wilcoxon-Ranks test. Results : EPI, FLAIR, and FSE T2 images showed high signal intensity lesions. The lesion discrimination was easier on EPI than on other sequences, and also EPI showed higher signal intensity for the subjective visual assessment. In quantitative evaluation, CNR of the hemorrhagic lesion versus normal brain parenchyma were higher on EPI and FLAIR images (p<0.01). There was no difference in CNR between EPI and FLAIR (p>0.10). On MR images obtained 30 minutes and 1 hour after the onset of intracerebral hemorrhage, the lesion detection was feasible on both EPI and FSE T2 images showing high signal intensity. Conclusion : EPI showed higher detection rate as compared with other MR sequences and could be useful in early detection and evaluation of intracerebral hemorrhage.

• Journal of Korean Neurosurgical Society
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• v.54 no.2
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• pp.125-127
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• 2013

Here, we report a rare case of an anaplastic astrocytoma masquerading as a hypertensive basal ganglia hemorrhage. A 69-year-old woman who had been under medical management for hypertension during the past 3 years suddenly developed right hemiparesis with dysarthria. Brain computed tomography (CT) scans with contrast and CT angiograms revealed an intracerebral hemorrhage (ICH) in the left basal ganglia, without an underlying lesion. She was treated conservatively, but underwent a ventriculoperitoneal shunt operation 3 months after the initial attack due to deteriorated mental status and chronic hydrocephalus. Three months later, her mental status deteriorated further. Magnetic resonance imaging (MRI) with gadolinium demonstrated an irregular enhanced mass in which the previous hemorrhage occurred. The final histological diagnosis which made by stereotactic biopsy was an anaplastic astrocytoma. In the present case, the diagnosis of a high grade glioma was delayed due to tumor bleeding mimicking hypertensive ICH. Thus, a careful review of neuroradiological images including MRI with a suspicion of tumor bleeding is needed even in the patients with past medical history of hypertension.