• Title/Summary/Keyword: Left side weakness

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A Case of Dural Arteriovenous Fistula of Superior Sagittal Sinus after Tamoxifen Treatment for Breast Cancer

  • Hwang, Sung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.57 no.3
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    • pp.204-207
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    • 2015
  • We are reporting an unusual case of dural arteriovenous fistula (AVF) of the superior sagittal sinus (SSS) after tamoxifen treatment for breast cancer. A 30-year-old female arrived at the emergency room with a sudden headache and left sided weakness and sensory loss. In her past medical history, she was diagnosed with breast cancer 1 year prior, and subsequently underwent a breast conserving mastectomy with whole breast radiation and adjuvant chemotherapy with tamoxifen. At the time of admission, computed tomography showed a small acute intracerebral hemorrhage at the right parietal cortex, and magnetic resonance imaging showed that a dural AVF at the SSS with a prominent and tortuous venous enhancement along the centrum semiovale was present. Cerebral angiography showed that the dural AVF at the mid-portion of the SSS with meningeal arterial feeding vessels entering the wall of the SSS, then draining through the dilated cortical veins. Our patient had no signs of active malignancy or any abnormalities in her coagulation profile, so it can be concluded that the tamoxifen was the likely cause of the SSS thrombosis and dural AVF. The dural AVF was treated by an endovascular coil embolization for the arterialized segment of the SSS. The patient dramatically recovered favorably from left side motor and sensory deficit. The best clinical approach is to screen potential patients of tamoxifen hormonal therapy and educate them on the sign and symptoms of life threatening thromboembolic events while taking tamoxifen.

Isolated Cortical Vein Thrombosis with Long Cord Sign

  • Ban, Seung Pil;Chung, Young Seob;Park, Sung Bae;Son, Young-Je
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.476-478
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    • 2015
  • Isolated cortical vein thrombosis (ICVT) is a rare disease, accounting for less than 1% of strokes. A 46-year-old woman presented with progressive left side weakness. Magnetic resonance (MR) imaging with $T2^*$-gradient echo ($T2^*$-GE) sequence showed long cord sign at the right frontal cortex. The patient was treated with low molecular weight heparin, followed by oral warfarin for 6 months. The 3-month follow-up MR imaging showed recanalization of the previously thrombosed cortical vein. She was completely recovered without neurological deficits after 6 months. This provides that MR imaging with $T2^*$-GE sequence can help to diagnosis the ICVT and outcomes of the ICVT are generally favorable.

Neuro-Behçet disease presented diplopia with hemiparesis following minor head trauma

  • Choi, Ja-Yun;Park, Sun-Young;Hwang, In-Ok;Lee, Young-Hwan
    • Clinical and Experimental Pediatrics
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    • v.55 no.9
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    • pp.354-357
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    • 2012
  • Behçet disease (BD) is rare in childhood. We report a 9-year-old boy with neuro-Behçet disease who presented diplopia and weakness on the left side after a cerebral concussion. Brain magnetic resonance imaging (MRI) revealed hyperintensity of the right mesodiencephalic junction on T2-weighted and fluid attenuated inversion recovery images. Prednisolone administration resulted in complete remission and normalization of abnormal MRI finding. Brain MRI is a useful diagnostic tool when the neurological sign is the first symptom of subclinical BD.

A Case of Cerebral Hemiatrophy Developed after Continued Epileptic Seizure (지속적 간질 이후에 발생한 일측대뇌반구위축증 (Cerebral hemitrophy)이 의심되는 환아(患兒) 1례(例)에 대한 증례보고(症例報告))

  • Cho, Hyung-Jun;Shin, Dong-Gil;Lee, Jin-Yong;Kim, Deog-Kon
    • The Journal of Pediatrics of Korean Medicine
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    • v.16 no.1
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    • pp.75-80
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    • 2002
  • A 10-year-old boy with a history of epileptic seizure for 3 years, showed ataxia and left side weakness. In Brain MRI, hemiatrophy of the right hemisphere was noted. So we considered that he had a cerebral hemiatrophy caused by continued epileptic seizure and treated him with herbal medicine, acupuncture and physical therapy. We report a case of a 10-year-old boy who showed symptoms of a cerebral hemiatrophy caused by maintained epileptic seizure.

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A Case of Lewis-Sumner Syndrome Improved by Oral Steroid Therapy (경구 스테로이드 치료로 호전된 Lewis-Sumner 증후군 1예)

  • Kim, Jong Kuk;Kim, Min-Jeong;Yoo, Bong-Goo;Kim, Kwang-Soo;Lim, Kwon Il
    • Annals of Clinical Neurophysiology
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    • v.8 no.1
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    • pp.102-105
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    • 2006
  • We present a case with stepwise weakness and sensory involvement of both hands for more than 2 months. His nerve conduction study findings revealed prolonged terminal latencies, decreased motor and sensory conduction velocities and conduction blocks of both ulnar nerves, more severely on left side. And there were other abnormalities manifested with mononeuropathy multiplex. Increased cerebrospinal fluid protein was found. We diagnosed him as Lewis-Sumner syndrome and tried high dose oral steroid therapy for 2 months. He showed improvement of motor functioning with persistent conduction block.

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Acute Ischemic Stroke in Moyamoya Syndrome Associated with Thyrotoxicosis

  • Kang, Donggook;Seong, Gi-Hun;Bae, Jong Seok;Lee, Ju-Hun;Song, Hong-Ki;Kim, Yerim
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.129-133
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    • 2018
  • Background: A few cases of moyamoya syndrome associated with thyrotoxicosis have been reported. However, studies on the association of hyperthyroidism with moyamoya syndrome are insufficient. Case Report: Here we report a case of hyperthyroidism associated with moyamoya syndrome in a 41-year-old woman with aphasia and right side weakness. Brain imaging revealed acute cerebral infarction of left middle cerebral artery territory and occlusion of bilateral distal internal carotid arteries. Conclusion: Antithyroid medication stabilized the patient's neurologic deterioration, suggesting that thyrotoxicosis could aggravate acute cerebral infarction caused by moyamoya syndrome.

Isolated facial diplegia variant of Guillain-Barré syndrome with anti-GM1 IgG antibody

  • Jung, Jin Ho;Lee, Sukyoon;Seo, Jung Hwa;Bae, Jong Seok;Shin, Kyong Jin;Kim, Jong Kuk;Yoon, Byeol-A;Oh, Seong-il
    • Annals of Clinical Neurophysiology
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    • v.24 no.1
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    • pp.17-20
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    • 2022
  • Facial diplegia (FD) rarely occurs as a regional Guillain-Barré syndrome (GBS) variant. A 70-year-old male presented with bifacial weakness that had started on the left side and extended to the right after several days. He was then treated using steroids and gradually improved. Serum antiganglioside antibody testing revealed positivity for anti-GM1 IgG antibodies. FD can be idiopathic, but it is an uncommon GBS variant. The ganglioside antibody test may increase the possibility of diagnosing isolated FD.

Distribution of Weakness at the Lower Extremity of Hemiparesis Patients (편측부전마비환자의 하지에서의 위약증상의 분포)

  • Park, Gun-Ju;Hah, Jung-Sang;Kim, Wook-Nyeun
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.101-110
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    • 1997
  • The maximal voluntary strength of knee extension and flexion on both the right and left sides was measured in patients with hemiparesis of upper motor neuron type and in a group of normal subjects. Significant differences of maximal voluntary strength were found between male and female but the ratio of flexor to extensor strength did not vary significantly between the sides, between the sex in normal subjects. The maximal voluntary strength of uninvolved side were not reduced significantly but involved side reduced significantly in patients. The ratio of flexor to extensor strength in hemiparetic side was significantly less than the ratio for the normal subjects but not significant difference in uninvolved side of patients. According to the above results, the maximal voluntary strength of flexion was more reduced than that of the extension in lower extremity of hemiparesis patients. The strength ratio of flexion to extension was a useful parameter for guiding the rehabilitation of hemiparesis.

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Mechanical Properties of Trabecular Bone in femoral Head & Neck (넙다리뼈 머리/목 부분 해면뼈의 기계적 물성)

  • Kwak Dai-Soon;Choi Kwang-Nam;Kim Sang-Kuk;Lee Sang-Ho;Kim Tae-Joong;Han Seung-Ho;Oh T.Y.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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    • pp.518-521
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    • 2005
  • We performed the mechanical test for obtaining properties of femoral head. Tested sample was male and 35 years old. We measured bone mineral density by dual X-ray absorption method(DEXA). Results of DEXA, he has normal condition of bone density. His BMD $1.159g/cm^2$ and T-Score is 1.6. Tested femurs were harvested by surgical method from donated cadaver. We made 9 specimens in femoral head, 8 specimens in neck used by diamond core drill. Then we performed compressive test in saline solution at $38^{\circ}C$. We obtained results that elastic modulus of femoral head was 0.439GPa, neck was 0.459GPa. Compressive strength of femoral head was 7.441 MPa, neck was 7.095MPa. There was no significant difference of mechanical properties between left and right femoral head & neck. Invested local properties of femoral head have more strength superior and anterior side, femoral neck has more strength in superior and inferior side but other side except for superior has more weakness along the lateral side.

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A Case Report of Complex Korean Medicine Treatment Including Modified Gamiguibi-tang in a Paraneoplastic Cerebellar Degeneration Patient with Dysarthria and Weakness of Distal Extremity (구음장애와 사지원위부 무력감을 호소하는 신생물딸림소뇌변성 환자에 대한 가미귀비탕가감방을 포함한 한의복합치료 1례)

  • Ji-hyeon Kang;Seo-hyun Kim;Chae-eun Kim;Hee-ju Won;Kyungmin Baek
    • The Journal of Internal Korean Medicine
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    • v.45 no.3
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    • pp.497-507
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    • 2024
  • Objectives: This study investigated the treatment response to Korean medicine of a paraneoplastic cerebellar degeneration (PCD) patient with dysarthria and weakness of distal extremity. Case presentation: A 53-year-old female diagnosed with PCD complained of dysarthria and weakness of distal extremity. During 32-day hospitalization, she was treated with Korean medicine, namely, herbal medicine (modified Gamiguibi-tang), acupuncture (15 minutes twice a day at CV23, HT7, LI4, LR3, ST36, SP6, GB20, TE17, PC6, GV20, Ex-HN1, GV24 etc.), moxibustion, and cupping, combined with Western medicine (prednisolone, azathioprine) and physical therapy. Post-treatment, the patient global assessment (PGA) score of dysarthria fell from 100 to 60; grasp power rose from 15 kg to 19 kg and 13 kg to 17 kg in the right and left hands, respectively; and the 5-level EQ-5D version (EQ-5D-5L), EQ visual analogue scale (EQ-VAS), and Beck depression inventory (BDI-II) scores changed from 10 to 8, 0 to 80, and 34 to 7 respectively. Follow-up visits continued for about a month after discharge, improvement in symptoms maintained, and there were no significant side effects. Conclusions: Given the lack of standard treatment for PCD, Korean medicine can be tried clinically for the treatment of PCD patients with dysarthria and weakness of distal extremity. However, further studies with control groups are needed.