• 한방재활의학과학회지
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• 제21권4호
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• pp.1-12
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• 2011

Objectives: This study was carried out in order to examine the effects of Gastrodiae rhizoma(GR) ethanol extract on neuronal apoptosis in intracerebral hemorrhage(ICH)-induced rats. Methods: ICH was induced by the stereotaxic intrastriatal injection of bacterial collagenase type VII in Sprague-Dawley rats. GR was orally given once a day for 3 days after ICH. Histological changes of the peri-hematoma regions were observed by cresyl vioIet staining. Bcl-2-associated X protein(Bax), B-cell blastoma 2(BcI-2) and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL) expressions in the affected regions were performed by immunohistochemistry. Results: 1. GR reduced apoptotic bodies and swelling neurons in the peri-hematoma regions of ICH-induced rats. 2. GR significantly reduced TUNEL positive cells in the peri-hematoma regions of ICH-induced rats. 3. GR significantly reduced Bax positive cells in the peri-hematoma regions of ICH-induced rats. 4. GR did not influence Bcl-2 expression in the peri-hematoma regions of ICH-induced rats. Conclusions: These results suggest that GR has neuroprotective effects against ICH-induced apoptosis.

• Journal of Korean Neurosurgical Society
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• 제45권6호
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• pp.341-349
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• 2009

Objective : The purpose of this study was to identify independent predictors of mortality and functional recovery in patients with primary intracerebral hemorrhage (PICH) and to improve functional outcome in these patients. Methods : Data were collected retrospectively on 585 patients with supratentorial PICH admitted to the Stroke Unit at our hospital between 1st January 2004 and the 31st July 2008. Using multivariate logistic regression analysis, the associations between all selected variables and 30-day mortality and 90-day functional recoveries after PICH was evaluated. Results : Ninety-day functional recovery was achieved in 29.1% of the 585 patients and 30-day mortality in 15.9%. Age (OR=7.384, p=0.000), limb weakness (OR=6.927, p=0.000), and hematoma volume (OR=5.293, p=0.000) were found to be powerful predictors of 90-day functional recovery. Furthermore, initial consciousness (OR=3.013, p=0.014) hematoma location (lobar, OR=2.653, p=0.003), ventricular extension of blood (OR=2.077, p=0.013), leukocytosis (OR=2.048, p=0.008), alcohol intake (drinker, OR=1.927, p=0.023), and increased serum aminotransferase (OR=1.892, p=0.035) were found to be independent predictors of 90-day functional recovery after PICH. On the other hand, a pupillary abnormality (OR=4.532, p=0.000) and initial unconsciousness (OR=3.362, p=0.000) were found to be independent predictors of 30-day mortality after PICH. Conclusion : The predictors of mortality and functional recovery after PICH identified during this analysis may assist during clinical decision-making, when advising patients or family members about the prognosis of PICH and when planning intervention trials.

• 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.

• 운동영양학회지
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• 제13권2호
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• pp.115-122
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• 2009

Intracerebral hemorrhage (ICH) is a common cause of stroke, and it occurs mainly in the striatum, thalamus, cerebellum, and pons. Physical exercise is known to ameliorate neurologic impairment induced by various brain insults. In the present study, the influence of pre-and post-conditioning of treadmill exercise on spatial learning ability, the lesion volume, and apoptotic neuronal cell death in the striatum following ICH in rats was investigated. ICH in the striatum was induced by injection of collagenase using strereotaxic instrument. The rats in the pre-exercise group were scheduled to run on a treadmill before ICH induction for 2 consecutive weeks. The rats in the post-exercise group were scheduled to run on a treadmill after ICH induction for 2 weeks. The rats in the pre-exercise and post-exercise group were scheduled to run on a preconditioning treadmill exercise 2 weeks before ICH induction until postconditioning treadmill exercise 2 weeks after ICH induction, except the day of surgery. For this study, radial arm maze task, Nissl staining, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, and immunohistochemistry for caspase-3 were performed. Our date showed that treadmill exercise suppressed the ICH-induced apoptotic neuronal cell death and decreased lesion volume in the stratum. Treadmill exercise also alleviated the ICH-induced impairment of spatial learning ability. Preconditioning treadmill exercise before the ICH insult and postconditioning treadmill exercise after the ICH insult showed similar effectiveness on the recovery of ICH. In this study, however, preconditioning exercise before the ICH insult and postconditioning exercise after the ICH insult showed the most potent effectiveness on the recovery of ICH.

• Korean Journal of Radiology
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• 제22권3호
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• pp.415-424
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• 2021

Objective: To determine whether noncontrast computed tomography (NCCT) models based on multivariable, radiomics features, and machine learning (ML) algorithms could further improve the discrimination of early hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (sICH). Materials and Methods: We retrospectively reviewed 261 patients with sICH who underwent initial NCCT within 6 hours of ictus and follow-up CT within 24 hours after initial NCCT, between April 2011 and March 2019. The clinical characteristics, imaging signs and radiomics features extracted from the initial NCCT images were used to construct models to discriminate early HE. A clinical-radiologic model was constructed using a multivariate logistic regression (LR) analysis. Radiomics models, a radiomics-radiologic model, and a combined model were constructed in the training cohort (n = 182) and independently verified in the validation cohort (n = 79). Receiver operating characteristic analysis and the area under the curve (AUC) were used to evaluate the discriminative power. Results: The AUC of the clinical-radiologic model for discriminating early HE was 0.766. The AUCs of the radiomics model for discriminating early HE built using the LR algorithm in the training and validation cohorts were 0.926 and 0.850, respectively. The AUCs of the radiomics-radiologic model in the training and validation cohorts were 0.946 and 0.867, respectively. The AUCs of the combined model in the training and validation cohorts were 0.960 and 0.867, respectively. Conclusion: NCCT models based on multivariable, radiomics features and ML algorithm could improve the discrimination of early HE. The combined model was the best recommended model to identify sICH patients at risk of early HE.

• Journal of Yeungnam Medical Science
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• 제8권2호
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• pp.35-44
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• 1991

저자들은 1990년 3월부터 1991년 2월까지 영남대학교 의과대학 부속병원 신경외과학교실에서 뇌정위적 수술을 시행하여 뇌실질내 출혈부위와 뇌실내에 모두 도관을 삽입한 자발성 뇌실질내 출혈 환자 30례에서 뇌압변화와 임상증상의 변화를 분석하였다. 자발성 뇌실질내 출혈은 40-60대에 주로 발생하였고, 여자가 2.3배로 많았으며, 출혈위치는 피각부, 시상부, 소뇌부 등의 순으로 많았다. 그리고 고혈압의 기왕력을 가진 사람이 많았으며, 고혈압과 연관된 심전도 소견을 보인 경우가 많았다. 평균 동맥혈 이산화탄소분압이 높은 환자에서 뇌압이 높았으며, 뇌압과 재출혈 및 퇴원시 ADL과는 유의한 관계는 없었다. 수술후 72시간경에 뇌압이 가장 높았으며, 뇌실질내 출혈 부위에 6000 IU 유로키나제 세척을 시행한 결과 유로키나제 세척후는 전에 비하여 평균 63.2%의 감압이 있었다. 뇌압이 높은 경우 Natural drainage를 많이 시행 했으나, Natural drainage 횟수와 퇴원시 ADL과는 유의한 상관 관계를 보이지 않았다. 처음 GCS이 높을수록 수술후에 GCS이 높았으며, 평균 뇌압이 높을수록 평균 GCS이 낮아 환자 상태가 나쁜 경우가 많았다.

• 대한한방내과학회지
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• 제40권4호
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• pp.730-741
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• 2019

Objective: The aim of this study was to report the effectiveness of traditional Korean medicine treatment with rehabilitation exercise on a chronic intracerebral hemorrhage patient with a severe gait disturbance. Method: The patient was treated with Korean herbal medicine (Gami-sibjeondaebo-tang) along with acupuncture, moxibustion, and rehabilitation exercise. The treatment effect was evaluated through the Manual Muscle Test (MMT) and the Korean version of the Modified Barthel Index (K-MBI). The gait of the patient was evaluated by Functional Ambulatory Category (FAC) and the Timed Up and Go (TUG) test. The spatiotemporal parameters were evaluated by a walkway system (GAITRite(R) system) and gait symmetry was evaluated by Symmetry Criterion (SC). Results: After 111 days of traditional Korean medicine treatment, the spatiotemporal parameters and symmetry of the patient's gait improved. Conclusion: This study suggested that traditional Korean medicine treatment with rehabilitation exercise could be effective for gait disturbance in patients with chronic intracerebral hemorrhage.

• Annals of Clinical Neurophysiology
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• 제1권1호
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• pp.55-59
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• 1999

Vasoconstriction of intracerebral arteries is the leading cause of delayed cerebral infarction and mortality following aneurysmal subarachnoid hemorrhage. Transcranial Doppler studies show and increase in the flow velocities of basal cerebral arteries, which usually start around day 4 following a subarachnoid hemorrhage, and peaking by days 7 to 14. Angiographic studies confirm the presence of at least some degree of MCA vasospasm when the flow velocities are higher than 100 cm/sec. Mean velocities in the 120 to 200 cm/sec range correspond to 25 to 50% luminal narrowing. MCA and ACA vsospasm is detected with around 90% specificity. Sensitivity is 80% and 50% respectively. A 200cm/sec threshold and rapid flow velocity increase exceeding 50 cm/sec on consecutive days, has been associated with subsequent infarction. Transcranial Doppler is also used to monitor the effects of endovascular treatment of vasospasm. Flow velocities decrease following successful angioplasty or papaverine infusion. Overall, transcranial Doppler studies are considered to have acceptable accuracy for the evaluation of vasospasm in aneurysmal subarachnoid hemorrhage, with limitations that have to be taken into consideration in the clinical setting.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.213-216
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• 2010

Spontaneous intracerebral hemorrhage (ICH) is a common condition that often leads to death or disability. Accurate prediction of the outcome and decisions regarding the treatment of ICH patients are important issues. We report a case of thalamic hemorrhage with an intraventricular hemorrhage that was suddenly migrated into the third and fourth ventricles in its entirety 8 hours after symptom onset. To our knowledge, this case is the first report of spontaneous migration of thalamic ICH into ventricles, and we suggest a possible mechanism for this case with a brief review of the literature.

• Journal of Korean Neurosurgical Society
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• 제38권4호
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• pp.303-305
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• 2005

The incidence of intracranial aneurysms in childhood is rare, especially in infancy. We report a case of a 45-day-old girl who presented with seizure due to a ruptured large saccular aneurysm of the middle cerebral artery[MCA] with subsequent subarachnoid, intracerebral and intraventricular hemorrhage. The baby has enjoyed an excellent clinical outcome after surgical management. The clinical features of the case and review of the literature are presented.