• Journal of Korean Neurosurgical Society
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• 제38권5호
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• pp.393-395
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• 2005

Cerebral infarction rarely occur following head injury. The authors present the case of a 39-year-old man with complete infarction in the middle cerebral artery[MCA] and anterior cerebral artery[ACA] territories ccurred immediately after head injury. He had compound depressed fracture in right frontal bone with no neurological deficit. After the depressed bone elevation, postoperative computed tomography scan showed the right MCA and ACA territory infarction with midline shift. Cerebral angiography obtained on the day after emergent decompressive craneictomy showed the complete occlusion of the internal carotid artery[ICA] at the level of lacerum ICA segment. There was no evidence of neck vessel dissection and basal skull fracture. Cerebral infarction can occur in an ultraearly period after head injury without neck vessel dissection or basal skull fracture. We stress the need for attention to the cerebral infarction as the cause of a rare neurological deterioration of the head trauma.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2001년도 제6차 학술대회 초록집
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• pp.170-170
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• 2001

Purpose： To evaluate the relationship between reperfusion hyperemia in reversible cerebral ischem and the degree of programmed cell death. Method： We produced the animal models of reversible cerebral ischemia in 10 cats by mean of middle cerebral artery (MCA) occlusion with transorbital approach. MCA was occluded b microvascular clamp for an hour. MR imaging was performed at 0, 1, 2 days after ischemi and reperfusion. Perfusion (PWI) [Contrast enhanced GRE EPI, TR/TE= 1500/40, 40 Phases, 128 matrix, 12 cm FOV] and diffusion (DWI) (SE EPI, b=0, 500, 1000) weighted images were obtained using Philips Intera 1.57 system. rCBV and ADC maps were calculated wi IDL based postprocessing program. Tissue slices were obtained after the last MR imagin TUNEL, Calbin and Acid-Fuscin staining were done for corresponding slices as MR imagin We investigated the differences of degree of apoptosis in the area of reperfusion hyperemia.

• Biomolecules & Therapeutics
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• 제7권3호
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• pp.234-241
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• 1999

The present study assessed the cerebroprotective effect of platelet-activating factor(PAF) antagonists in transient cerebral ischemia of rats. Right middle cerebral artery (MCA) of Sprague-Dawley rats was occluded for 2 hours using an intraluminal filament technique, and was reperfused for 6 hours following cerebral ischemia. The infarct area of seven coronal brain slices was measured morphometrically following stain ing in the 2% 2,3,5-triphenyltetrazolium chloride solution. The changes in regional cerebral blood flow (rCBF) and pial arteriolar diameter were measured by laser-Doppler flowmetry and by a videomicroscopy, respectively. The infarct size was significantly reduced by PAF antagonists, BN 52021 and CV-6209, which were administered i.p. 10 min before MCA occlusion. Pretreatment with PAF antagonists significantly restored the changes in pial arterial diameter as well as those in rCBF during the period of cerebral ischemia-reperfusion. PAF antagonists significantly inhibited the inducible nitric oxide synthase activity in the pial arteries ipsilateral to ischemia. These results suggest that PAF antagonists exert a cerebroprotective effect against ischemic brain damage through an improvement of postocclusive cerebral blood flow.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.352-356
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• 2016

Objective : The efficacy and safety of manual aspiration thrombectomy using Penumbra in an acute occlusion of large intracranial arteries has been proven in many previous studies. Our study aimed to retrospectively assess the efficacy and safety of manual aspiration thrombectomy using Penumbra in patients with small vessel occlusions (M2 segment of the MCA). Methods : We conducted a retrospective review of 32 patients who underwent manual aspiration thrombectomy using the Penumbra 4 MAX Reperfusion Catheter for treatment of an M2 occlusion between January 2013 and November 2014. We evaluated immediate angiographic results and clinical outcomes through review of patient electronic medical records. Results : There were slightly more men in this study (M : F=18 : 14) and the median age was 72.5 (age range : 41-90). The rate of successful recanalization (TICI grade ${\geq}2b$) was 84% (27/32). NIHSS at discharge and favorable clinical outcomes at 3 months were significantly improved than baseline. Median initial NIHSS score was 10 (range : 4-25) and was 4 (range : 0-14) at discharge. Favorable clinical outcomes (mRS score ${\leq}2$ at 3 months) were seen in 25 out of 32 patients (78%). There were no procedure-related symptomatic intracerebral hemorrhages. One patient expired after discharge due to a cardiac problem. Conclusion : Manual aspiration thrombectomy might be safe and is capable of achieving a high rate of successful recanalization and favorable clinical outcomes in patients with distal cerebral vessel occlusion (M2).

• Journal of Korean Biological Nursing Science
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• 제2권2호
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• pp.67-80
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• 2000

The purpose of this study was to identify hindlimb muscle atrophy in stroke induced rat and determine the effect of endurance exercise on body weight, weight of hindlimb muscle during 7 days after stroke induction. Thirty four male Sprague-Dawley rats with 200-270g body weight were divided into four groups : control, control+exercise(Con+Ex), stroke, and exercise after stroke(St+Ex) group. The control group and Con+Ex group received sham operation and the stroke group and St+Ex group received right MCA occlusion operation by using silicon-coated probe. The Con+Ex and St+Ex groups ran on a treadmill for 20min/day at 10m/min and $10^{\circ}grade$. Daily body weight and diet intake were measured every morning for 7 days. Cerebral infarction of stroke and St+Ex groups were identified by staining with TCC for 30minutes. The data were analyzed by Kruskal-Wallis test and Mann-Whitney U test using the SPSSWIN 9.0 program. Body weight of the control group at the 7th day increased by 18.3% significantly from the first day of experiment, that of the stroke group at the 7th day decreased by 6.7% significantly compared to the day of receiving right MCA occlusion operation. Body weight of the Con+Ex group at the 7th day increased by 10.3% significantly form the first day of experiment, that of St+Ex group at the 7th day also increased by 13.4% significantly compared to the day of receiving right MCA occlusion operation. The total amount of diet in stroke group decreased significantly compared to that of St+Ex and that of control group. In stroke group the wet weight of both sides of soleus, plantaris, and gastrocnemius muscles decreased significantly compared to that of control group. The relative weight of affected(left) plantaris and gastrocnemius muscles decreased significantly compared to that of the control group. The difference between the weight of affected and unaffected soleus, plantaris, and gastrocnemius muscles were not significant in stroke group. The wet weight of right gastrocnemius muscles in Con+Ex group increased compared to that of control group. The relative weight of right gastrocnemius muscle increased significantly compared to that of the control group. The wet weight of St+Ex group increased significantly compared to that of the stroke group in both sides of soleus, plantaris, and gastrocnemius muscles. The relative weight of affected plantaris muscle increased significantly compared to that of the stroke group. The difference between the weight of affected and unaffected soleus, plantaris, and gastrocnemius muscles were not significant in St+Ex group. Body weight and wet weight of soleus, plantaris, and gastrocnemius muscles in the St+Ex group did not recover to the values of control group. Based on these results, it can be suggested that endurance exercise during acute stage of stroke can reduce muscle atrophy related to denervation, inactivity and undernutrition.

• 대한한의학회지
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• 제26권2호
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• pp.217-230
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• 2005

Objectives: Chungpaesagan-tang (CPSGT), which is frequently used for treating patients of cerebrovascular disease, has not been reported by clinical doctors concerning the effect of neuronal aptosis caused by brain ischemia. To study the effect of CPSGT on focal cerebral ischemia in normal and diabetic rats and SHR, focal cerebral ischemia was induced by transient MCAO, and after onset CPSGT was administrated. Methods: Rats (Sprague-Dawley) were divided into four groups: sham-operated group, MCA-occluded group, CPSGT­administrated group after MCA occlusion, and normal group. The MCA was occluded by intraluminal method. CPSGT was administrated orally twice (l and 4 hours) after middle cerebral artery occlusion. All groups were sacrificed at 24 hours after the surgery. The brain tissue Was stained with $2\%$ triphenyl tetrazolium chloride (TTC) or $1\%$ cresyl violet solution, to examine effect of CPSGT on ischemic brain tissue. The blood samples were obtained from the heart.~. Tumor necrosis $factor-\alpha$ level and interleukin-6 level of serum was measured from sera using enzyme-linked immunoabsorbent assay (ELISA). Then changes of immunohistochemical expression of $TNF-\alpha$ in ischemic damaged areas were observed. Results: In NC+MCAO+CP and DM+MCAO+CP, CPSGT significantly (p<0.01) decreased the number of neuron cells compared to the control group. CPSGT markedly reduced (p<0.01) the infarct size of the forebrain in distance from the interaural line on cerebral ischemia in diabetic rats. CPSGT significantly reduced the $TNF-\alpha$ expression in penumbra region of damaged hemisphere in diabetic rats. Conclusions: CPSGT had a protective effect on cerebral ischemia in SD rats, especially in diabetic rats compared with normal SD rats.

• 대한중풍순환신경학회지
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• 제7권1호
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• pp.1-10
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• 2006

Objectives : Yanggyuksanhwa-tang is a prescription used for cerebral infarction clinically. Methods : According to previous research data, the effect of Yanggyuksanhwa-tang on cerebral infarction, we induced cerebral infarction by middle cerebral artery occlusion(MCAO) in rats, and the rats were administered Yanggyuksanhwa-tang. Results: Infarct area, infarct volume were measured, and the level of elements such as c-Fos, Bax and caspase-3 in penumbra of infarct were expressed by immunohistochemical staining. Conclusion : Yanggyuksanhwa-tang showed neuroprotective effect through preventing neuronal cell apoptosis.

• 동의생리병리학회지
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• 제17권1호
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• pp.64-70
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• 2003

Jaeumgenby-tang(JGT) have been used in oriental medicine for many centuries as a therapeutic agent of vertigo caused by deficiency of qi(氣) and blood(血). Effect of Aurantii Fructus(AF) take off the phlegm by promoting the circulation of qi, Gastrodae Rhizoma(GR) has effects treating for headache, vertigo by calming the liver and suppressing hyperactivity of the liver-yang(陽). And, I designed to investigate whether injection of JGT adding AFㆍGR extract(JGTAG) affects cytotoxicity in vitro, cerebral hemodynamics [regional cerebral blood flow(rCBF), pial arterial diameter(PAD), mean arterial blood pressure(MABP)] in normal and cerebral ischemia rats by MCA occlusion method. The changes of rCBF and MABP were determinated by laser-doppler flowmetry(LDF), and the change of PAD was determinated by video microscope and width analyzer. The results were as follows in normal rats; JGTAG was not cytotoxicity in brain cells. And JGTAG was significantly increased rCBF, PAD and MABP. This results suggest that JGTAG increased significantly rCBF by dilating PAD. And the results were as follows in cerebral ischemic rats; The changes of rCBF and PAD were increased stably by treatment with JGTAG(10mg/kg, i.v.) during the period of cerebral reperfusion, and pretreatment with propranolol and indomethacin were increased JGT AG induced increase of rCBF and PAD during the period of cerebral reperfusion. We suggest that JGTAG has an anti-ischemic effect through the improvement of cerebral hemodynamics.

• Nuclear Medicine and Molecular Imaging
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• 제42권1호
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• pp.8-16
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• 2008

목적: 내경동맥 또는 중대뇌동맥의 죽상 동맥 경화증 환자에서의 두개외강-내강 우회로술(이하 우회로술) 후의 연속적인 혈류 역학적 변화를 $^{99m}Tc$-ECD 아세타졸아마이드 부하 뇌혈류 단일 광자 방출 전산화 단층 촬영(이하 아세타졸아마이드 부하 SPECT)으로 평가하여 중대뇌 동맥의 각 분지별 영역에 대한 우회로술의 혈류역학적 개선효과를 알아보고자 하였다. 대상 및 방법: 전향적 방법으로 최근 3개월 내에 혈관 폐색성 징후가 발생하여 우회로술을 시행받은 환자를 대상으로 수술 전과 수술 1 주 후, 3-6 개월 후에 아세타졸아마이드 부하 SPECT를 시행하였다. 영상 분석을 위해 SPM의 SPECT 표준 뇌에 공간 정규화한 후 Anatomical Automated Labeling으로 중대뇌동맥의 지배를 받는 양측 전두, 측두, 두정 영역에 관심 구역을 설정하여 각 관심 영역별로 뇌혈류 지표(PI; $C_{region}/C_{ipsilateral\;cerebellum}$) 및 뇌혈관 예비능 지표$((PI_{acetazolamide}-PI_{basal})/PI_{basal})$로 정하여 이들 지표의 수술 전후 변화를 평가하였다. 결과한 측에 성공적인 우회로술을 시행한 환자 17 명(남:여=12:5, 나이 $53{\pm}2$세)을 분석하였다. 전체적으로 뇌혈류는 수술 1 주 후 유의하게 증가하나 3-6 개월 후 감소하여 수술 이전의 수준으로 유지되었으며 ($1.01{\pm}0.09{\rightarrow}1.06{\pm}0.09}{\rightarrow}1.02{\pm}0.10,\;p=0.005$) 뇌 혈관 예비능은 수술 1 주 후 유의하게 증가한 이후 유의하지는 않으나, 3-6개월 이후까지 계속 호전되었다($-0.14{\pm}0.05{\rightarrow}-0.07{\pm}0.04{\rightarrow}0.05{\pm}0.05,\;p=0.004$). 각 뇌 영역별로 뇌혈류는 두정 영역에서 수술 직후 증가하였다가($1.12{\pm}0.09{\rightarrow}1.18{\pm}0.09,\;p=0.003$) 수술 3-6개월 이후 감소하여($1.12{\pm}0.09,\;p=0.003$) 수술 이전의 수준으로 유지되었다. 뇌혈관 예비능은 수술 측의 전두 영역($-0.15{\pm}0.07{\rightarrow}0.08{\pm}0.05$), 두정 영역($-0.16{\pm}0.07{\rightarrow}-0.07{\pm}0.05$)에서 모두 수술 직후 유의하게 증가하였고(p<0.01) 이후 유의하지는 않으나 3-6개월까지 계속 호전되었다. 결론: 성공적인 우회로술 후 뇌혈류는 전체적으로 유의한 변화가 없었으나 뇌혈관 예비능은 중대뇌동맥 영역 전체에 걸쳐 수술 후 단기간에 유의한 호전을 보였으며 장기간 유지되었다. 따라서 뇌혈관 예비능의 호전여부는 우회로술에 의해 증가된 뇌관류압을 평가할 수 있는 중요한 지표로 생각되며 향후 우회로술에 의한 뇌졸중 재발방지 효과를 알아보기 위해 뇌혈관 예비능의 변화와 예후와의 상관관계에 대한 연구가 필요하리라 생각된다.

• 대한한방내과학회지
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• 제29권3호
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• pp.629-640
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• 2008

Objective : The purpose of this study was to investigate the neuroprotective effect of Jukryuk on 4-vessel occlusion(4-VO) and middle cerebral artery (MCA) ischemia. Method : After administration of Jukryuk, we compared the Jukryuk-treated group, the control, and the sham groups, in view of several points as follows 1) We evaluated the damage characterized by coagulative cell change of pyramidal neurons and pronounced gliosis in each group 2) We counted the number of normal pyramidal shapes after ischemia in each group 3) Immunohistochemistry (cyclooxygenase-2) 4) In focal ischemic injury model, we measured the volume of ischemic area Results : In this experiment, the effect of Jukryuk was determined to be protecting neuron cell shape, reducing the number of neuron cells damaged by ischemia and the volume of the ischemic area. In immunohistochemistry, Jukryuk reduced cyclooxygenase-2 expression Conclusions : According to this study, Jukryuk can protect neuron cells from injury by cerebrovascular ischemia.