• Title/Summary/Keyword: Neurologic examination

검색결과 159건 처리시간 0.021초

전방순환 뇌경색의 중재적 재관류 치료 이후 출혈 변환으로 의식 및 인지장애를 동반한 편마비환자의 한방치험 1례 (The Effect of Korean Medicine Treatment for Hemorrhagic Transformation after Interventional Reperfusion Therapy of an Anterior Circulation Infarction in a Patient with Hemiplegia and Conscious and Cognitive Disorders: A Case Report)

  • 김채은;강지현;김서현;김준석;백경민
    • 대한한방내과학회지
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    • 제43권6호
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    • pp.1274-1288
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    • 2022
  • Objectives: The study investigated the effect of Korean medicine treatment on a hemiplegic patient with conscious and cognitive disorders due to hemorrhagic transformation after interventional reperfusion therapy of anterior circulation infarction. Case presentation: The patient was treated with acupuncture, moxibustion, cupping, and herbal medicine in combination with Western medicine and physical therapy. The effects on clinical symptoms were evaluated using the Manual Muscle Test (MMT), Glasgow Coma Scale (GCS), Korean Mini-Mental State Examination (K-MMSE), Korean Nursing Delirium Screening Scale (Korean Nu-DESC), and Modified Bathel Index (MBI). After the treatment, the MMT grade increased from Gr.0-1 to Gr.0-3, the GCS score increased from 10 to 15, the K-MMSE score increased from 8 to 15, the Korean Nu-DESC score decreased from 3 to 1, night delirium disappeared, and the MBI score increased from 13 to 26. Conclusions: Complex Korean medicine treatments were effective for improving the clinical symptoms of hemorrhagic transformation after interventional reperfusion therapy for anterior circulation infarction in a patient with hemiplegia and conscious and cognitive disorders. However, further studies are needed.

급성기 뇌경색 환자의 전조증상 유무에 따른 특성 비교 (Investigation on Warning Signs of the patients with Acute Ischemic Stroke)

  • 정재한;선종주;정우상;문상관;조기호;고성규;전찬용;한창호
    • 대한중풍순환신경학회지
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    • 제7권1호
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    • pp.59-64
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    • 2006
  • Objective : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : Three-hundred sixty three acute stroke patients were recuited in the oriental medical hospitals of 3 universities located in metropolitan region from October in 2005 to October in 2006. We evaluated their stroke type with brain MRI, their waring signs, and general characteristics such as age, sex, past history, risk factor, etc. Result : Of the 363 patient, 138(38%) patients were experience of warning signs. The frequency of Stress were found more in experience of warning signs than none of them. Warning signs were more common in Large Artery Atherosclerosis than in the other etiology. Conclusion : Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which their patients appeal. For the further investigation, it seems to be necessary to construct fundamental databases for stroke by increasing the number of patients and by examination into the etiology and location.

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비기질적 원인에 의한 신경학적 증상 감별법에 대한 고찰: 사례를 중심으로 (A Review of Diagnostic Methods on Neurologic Symptoms by Non-organic Causes: A Case of a Patient)

  • 조민경;임정화;박승찬;김도형;김소연;최준용;한창우;박성하;홍진우;권정남;이인
    • 동의신경정신과학회지
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    • 제25권1호
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    • pp.63-72
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    • 2014
  • Objectives: The objective of this study is to review the diagnostic methods of neurologic symptoms by non-organic causes. Methods: We experienced a case of a motor and sensory disturbance patient without abnormal findings in the diagnostic tests. Using this process, we became aware that it is important to remember some of the methods when treating patients who are suspicious of neurologic symptoms by non-organic causes. Results: First, we should perform a variety of diagnostic tests to exclude the organic causes. Second, we should persistently observe a consistency of the patient's symptoms and attitude. Finally, we should perform a neurological examination in order to acquire the objective physical findings. Conclusions: Because there are limitations in the methods above, we have to be aware of making a mistake regarding the disability by organic causes as that by non-organic causes.

Chondrosarcoma Apoplexy in Thoracic Spine

  • Kim, Sang Woo;Kim, Min Su;Jung, Young Jin
    • Journal of Korean Neurosurgical Society
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    • 제53권1호
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    • pp.46-48
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    • 2013
  • Chondrosarcoma is a very uncommon malignant primary bone tumor, especially, it occurs extremely rare in the spine. A 52-year-old man was admitted to the emergency room with sudden paraplegia. Twelve hours prior to a paraplegic event, he visited an outpatient clinic with discomfort and tenderness around the medial border of the right scapular, and his neurologic status was absolutely intact. Magnetic resonance imaging showed a lobulated soft tissue mass from T3 to T5, which extended to the epidural space. Computed tomography scans showed soft tissue mass on the spinal posterior arch and osteolytic change of the adjacent bony structures. Emergent surgery was performed and the lesion was removed. Dark reddish blood and gel-like material were encountered around the dura and posterior arch during the operation. Multiple pulmonary nodules were found on a chest CT scan and a biopsy of one of them had been proven to be a metastasis of chondrosarcoma. The histologic examination showed dedifferentiated chondrosarcoma. The patient's neurologic deficit was improved slowly from ASIA A to ASIA D. Chondrosarcoma in the spine is extremely rare, even more with acute hemorrhage and sudden expansion into the epidural space. We named it chondrosarcoma apoplexy. We should consider the possibility of a hemorrhagic event when the patient's neurologic deficit worsens suddenly with spinal bone tumor.

만성 신부전을 초래한 Hinman 증후군 1례 (A Case of Hinman Syndrome Complicated by Chronic Renal Failure)

  • 이경훈;이은실;박용훈
    • Childhood Kidney Diseases
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    • 제2권1호
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    • pp.90-94
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    • 1998
  • Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

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외상 후 우연히 발견된 고리뼈 활의 선천적 결손 (증례 보고) (Congenital Defects of the Atlantal Arch Presenting Incidentally after Trauma)

  • 이승택
    • Journal of Trauma and Injury
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    • 제26권1호
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    • pp.30-33
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    • 2013
  • A 55-year-old woman was seen in the emergency department with posterior neck pain and a headache after a traffic accident. Physical examination revealed tenderness on palpation over the posterior skull and a midline spinous process of the cervical spine without neurologic deficit. A plain radiograph of the cervical spine demonstrated the absence of the lateral portion of the posterior arch of the atlas and very lucent shadowing of the anterior midline of the atlas, suggesting a fracture of the anterior arch. On three-dimensional computed tomography (CT) of the cervical spine, anterior and posterior bony defects of the atlas were noted. Well-corticated defects were noted with sclerotic change and with no evidence of soft tissue swelling adjacent to the bony discontinuities, consistent with a congenital abnormality. With conservative therapy, the patient gradually showed a lessening of the midline tenderness. Careful investigation with radiography or CT is needed for these patients to avoid confusion with a fracture, because these patients seldom need surgical treatment.

홍역 감염 후 발생한 양측성 시신경염 1례 (Bilateral Optic Neuritis after Measles Infection)

  • 황성현;김종현;오진희;고대균
    • Pediatric Infection and Vaccine
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    • 제11권2호
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    • pp.192-197
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    • 2004
  • A 9-year-old boy who was confirmed measles by clinical manifestations and serum measles IgM antibody presented with bilateral visual loss 12 days after the onset of maculopapular rash. Complete ophthalmic and neurologic examinations, radiologic studies, and lumbar puncture were performed. Visual acuities were counting fingers in both eyes, with mild bilateral optic disk hyperemia and swelling noted. Neurologic examination was unremarkable, however, a magnetic resonance imaging of the brain showed high signals on basal ganglia, and periventricular white matter. The cerebrospinal fluid was devoid of white cells. Intravenous methylprednisolone and high dose immunoglobulins were administered, and clinical findings resolved completely within 6 months.

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개에서 Discospondylitis의 진단과 치료 일례 (A case of Discospondylitis in a Dog)

  • 김주민;송상범;황철용;윤정희;윤화영;한홍율
    • 한국임상수의학회지
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    • 제19권4호
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    • pp.436-439
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    • 2002
  • Discospondylitis is an infection of an intervertebral disk with concurrent osteomyelitis of contiguous vertebrae. Clinical signs are variable and include pain, fever, anorexia, weight loss, depression, stilted gait and paresis or paralysis. A seven-year-old, intact female Yurkshire terrier dog was refered to the Vfterinary Medicine Teaching Hospital of Seoul National University because of intermitent pain of unknown cause for 2 weeks. On physical examination, pain was evident when spines were manipulated, especially thoracolumbar junction part. No neurologic deficits were deteced in the general neurologic test. Spinal radiography demonstrated the bony lysis of the vertebral end plates and sclerosis of the $T_{12-13}$ vertebral body. Based on the results of examinations, the dog was diagnosed as discospondylitis and recoverd following antibiotic therapy.

소형견 15예의 흉요추추간판질환에 대한 보존치료 (The Effect of Conservative Therapy on Thoracolumbar Intervertebral Disc Disease on 15 dogs)

  • 한현정;정순욱;김준영;정만복;김지선
    • 한국임상수의학회지
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    • 제20권1호
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    • pp.52-58
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    • 2003
  • Fifteen dogs with clinical signs of paraparesis, paraplegia and urinary dysfunction were referred to Veterinary Medical leaching Hospital, College of Veterinary Medicine, Konkuk University. According to physical and neurologic examination, survey radiograph and myelography, these patients were diagnosed as thoracolumbar intervertebral disc disease. All of them were treated with medical (prednisolone or carprofen, antibiotics), acupuncture (Ji Zhong, Bai Hui, Zhong Shu, Pang Guang Shu, Zu San Li, Huan Tiao) and physical therapy (hydrotherapy, thermotherapy, massage, manipulation, swimming). Of twelve patients were recovered of neurologic deficits within 21 days after the onset of treatment. However, three dogs were not resolved, which were found to have other spinal cord disease concomitantly. All of patients showed normal urination after treatment. Until 21 months after treatment, there were no recurrence in twelve patients. This study indicated that the conservative therapy could be effectively managed in paraparesis or paraplegia and urinary dysfunction which caused by intervertebral disc disease.

내장 신경 차단후 합병된 양측 서혜부의 지각 탈실 (Dysaesthesia of Inguinal Area Following Splanchnic Nerve Block with Alcohol)

  • 이자원;윤덕미;오흥근
    • The Korean Journal of Pain
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    • 제7권1호
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    • pp.116-118
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    • 1994
  • 무수 알코올로 내장신경차단 완료후 양측 서혜부 상하의 지각 탈실, 이상감감이 합병되었다, 차단 6일 후부터 지속적 경막외차단을 시작하여 점차 이상감각 및 통증은 조절되었으며 지각탈실 부위도 점차 축소되었다.

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