• Journal of Acupuncture Research
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• 제19권5호
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• pp.35-45
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• 2002

Objective : The aim of this study was to investigate the effect of tong's acupuncture on recovery of motor disorders in stroke patients. Methods : Twenty two patients with poststroke-hemiplegia were randomized into two groups. Ten patients(test group) treated by 2 methods-tong's acupuncture and body acupuncture. The other twelve patients(control group) treated only by body acupuncture. The activity of daily living was measured with a National Institutes of Health stroke scale(NlHSS) and Modified Barthel Index(MBI). The therapy was performed one a day for 2 weeks. Results: In terms of score of NIHSS. the test group showed statistically meaningful decrease after 2 week treatment. but the control group showed statistically meaningful decrease after I week(p<0.05). And in terms of score of MBI. the test group showed statistically meaningful increase after 2 week treatment. but the control group showed statistically meaningful increase after I week(p<0.05). There was no statistically meaningful difference after 1 and 2 week treatment between the groups. Conclusions: These results support that test group has almost same effectness compared with control group in improvement of the activity of daily living of poststroke-hemiplegic patients.

• 대한한방내과학회지
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• 제37권5호
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• pp.733-740
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• 2016

Objective: To evaluate the effects of integrative treatment with conventional and Korean medicine on cerebral infarction due to presumed paradoxical embolism through a patent foramen ovale. Methods: We applied acupuncture, herbal medication, western medication, and physical therapy routinely every day and applied fluid therapy provided as needed. The NIHSS, K-MBI, MRS, MMT, and MMSE-K score were determined to assess any improvement in symptoms. Results: Scores appeared to be improved for the NIHSS (9 to 5), K-MBI (94 to 100), MRS (2 to 1), MMT (2+, 4 to 4, 4), MMSE-K (24 to 26). No side effects were observed during the treatment. Conclusions: This study demonstrates that integrative treatment with conventional and Korean medicine may be an effective option for treating cerebral infarction due to a presumed paradoxical embolism through a patent foramen ovale.

• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.428-432
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• 2010

Objective : An effective intervention has not yet been established for patients with acute occlusion of the internal carotid artery (ICA). The aim of our study was to investigate the feasibility, safety, and efficacy of emergent stent placement of carotid artery to improve neurologic symptoms and clinical outcome. Methods : Of 84 consecutive patients with severe ICA stenosis who were admitted to our institution from March 2006 to May 2009, 10 patients with acute ICA occlusion (11.9%) underwent emergency carotid artery stent placement. We reviewed their records for neurologic outcome using the National Institutes of Health Stroke Scale (NIHSS) score, before and at 7 days after stent placement; clinical outcome using the modified Rankin Scale score (mRS) and Glasgow Outcome Scale (GOS); frequency of procedure-related complications; and recurrence rate of ipsilateral ischemic stroke within 90 days. Results : Carotid lesions were dilated completely in all patients. Median NIHSS scores before emergency stent placement and at 7 days were 16.6 and 6, respectively, showing significant improvement. Eight patients (80%) had favorable outcomes (mRS score 0-2 and GOS 4-5). Complications occurred in two patients (20%): stent insertion failed in one and an intracerebral hemorrhage occurred in the other. Ipsilateral ischemic stroke did not recur within 3 months. Conclusion : Emergency carotid artery stent placement can improve the 7-day neurologic outcome and the 90-day clinical outcome in selected patients with acute cerebral infarction.

• Journal of Korean Neurosurgical Society
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• 제47권4호
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• pp.258-264
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• 2010

Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

• 대한한방내과학회지
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• 제39권5호
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• pp.1015-1022
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• 2018

Objectives: The aim of this study is to describe the effects of traditional Korean medicine treatment on a patient with an intracerebral hemorrhage (ICH) at the left basal ganglia. Methods: The patient was treated with herbal medicine (Gamicheongsim-tang, Hwangryunhaedok-tang-tablet), acupuncture, moxibustion, and rehabilitative therapy. The effects of these treatments were evaluated using the manual muscle test (MMT), sensory scale, Korean version of the modified Barthel index (K-MBI), and the National Institutes of Health Stroke Scale (NIHSS). Results: After treatment, the MMT grade improved from 3+/3+ to 4+/4+, and the sensory scale increased from 40%/40%/40% to 80%/80%/80%. In addition, the K-MBI score improved from 56 to 100, and the NIHSS score decreased from 7 to 1. Conclusion: The results suggest that traditional Korean medicine can be effective in the treatment of patients with ICH.

• Journal of Korean Neurosurgical Society
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• 제45권6호
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• pp.360-368
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• 2009

Objective : The objectives of this study were to analyze the recanalization rates and outcomes of multimodal therapy that consisted of sequential intravenous (IV)/intra-arterial (IA) thrombolysis, mechanical thrombolysis including mechanical clot disruption using microcatheters and microwires, balloon angioplasty, and stenting for acute ischemic stroke, and to evaluate the prognostic factors related to the outcome. Methods : Fifty patients who were admitted to the hospital within 8 hours from ischemic symptom onset were retrospectively analyzed. Initial IV thrombolysis and subsequent cerebral angiography were performed in all patients. If successful recanalization was not achieved by IV thrombolysis, additional IA thrombolysis with mechanical thrombolysis, including balloon angioplasty and stenting, were performed. The outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS) change and modified Rankin scale (mRS) and prognostic factors were analyzed. Results : Successful recanalization was achieved in 42 (84%) of 50 patients, which consisted of 8 patients after IV thrombolysis, 19 patients after IA thrombolysis with mechanical clot disruption, and 15 patients after balloon angioplasty or stenting. Symptomatic hemorrhage occurred in 4 (8%) patients. Good outcomes were achieved in 76% and 70% of patients upon discharge, and 93% and 84% of patients after 3 months according to the NIHSS change and mRS. The initial clinical status, recanalization achievement, and presence of symptomatic hemorrhage were statistically related to the outcomes. Conclusion : Multimodal therapy may be an effective and safe treatment modality for acute ischemic stroke. Balloon angioplasty and stenting is effective for acute thrombolysis, and produce higher recanalization rates with better outcomes.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.201-208
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• 2019

Objective : In patients with internal carotid artery (ICA) occlusion, collateral middle cerebral artery (MCA) flow has a protective role against ischemia. However, some of these patients may experience initial major neurological deficits and major worsening on following days. Thus, we investigated the safety and efficacy of endovascular treatment (EVT) for ICA occlusion with collateral MCA flow by comparing clinical outcomes of medical treatment versus EVT. Methods : The inclusion criteria were as follows : 1) acute ischemic stroke with ICA occlusion and presence of collateral MCA flow on transfemoral cerebral angiography (TFCA) and 2) hospital arrival within 12 hours from symptom onset. The treatment strategy was made by the attending physician based on the patient's clinical status and results of TFCA. Results : Eighty-one patients were included (30 medical treatment, 51 EVT). The EVT group revealed a high incidence of intracranial ICA occlusion, longer ipsilesional MCA contrast filling time, and a similar rate of favorable clinical outcome despite a higher mean baseline the National Institutes of Health Stroke Scale (NIHSS) score. By binary logistic regression analysis, intravenous recombinant tissue plasminogen activator and EVT were independent predictors of favorable clinical outcome. In subgroup analysis based on stroke etiology, the non-atherosclerotic group showed a higher baseline NIHSS score, higher incidence of EVT, and a higher rate of distal embolization during EVT in comparison with the atherosclerotic group. Conclusion : In patients with ICA occlusion and collateral MCA flow, decisions regarding treatment strategy based on TFCA can help achieve favorable clinical outcomes. EVT strategy with respect to etiology of ICA occlusion might help achieve better angiographic outcomes.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.102-109
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• 2018

Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

• 혜화의학회지
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• 제23권1호
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• pp.125-135
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• 2014

Objectives : The purpose of this study is to detect the change of pattern according to phase and to identify the associated factors with depression in stroke patients. Methods : The study was designed as a longitudinal study. Data was collected from 90 subjects, who were diagnosed with stroke using a brain MRI. The instruments included rehabilitation will, social support, FIM(Functional Independence Measure), NIHSS(National Institute of Health Stroke Scale), and BDI(Beck Depression Index). The collected data were analyzed using by SPSS 19.0 program package. Results : There were significant differences of depression pattern among the three phases. The most depression associated factor was the level of FIM. Conclusion : These results will support strategies for intervention to improve depression of stroke patients. Most affecting factors should be considered for depression intervention.

• 대한한의학회지
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• 제23권4호
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• pp.9-14
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• 2002

To assess the clinical efficacy of Chungpyesagan-tang on acute stroke, we prescribed this medicine to 88 acute stroke patients without thrombolytic treatment. The rate of progressive stroke type was 2.3%, remarkably lower than in previous reports. 1.1 % felt an itching sensation, and 17.0% complaxined of loose stool and diarrhea. Chungpyesagan-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale (NIHSS), and increased Modified Barthel Index (MBI). Thus, we could suggest that this medicine has a desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, ALT had anupward tendency and increased over normal value in 16 cases (18.2%). However, the mean serum level 2 weeks later was within the normal value and the other hepatic enzymes did not increase.