• Title/Summary/Keyword: Neurological examination

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A Case of Delayed encephalopathy after Acute Carbon Monoxied Intoxication (일산화탄소 중독 후 발생된 지연성 뇌병증 환자의 치험 및 호전 1예)

  • 김동은;김경훈;김정석;신길조;이원철
    • The Journal of Korean Medicine
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    • v.22 no.3
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    • pp.169-178
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    • 2001
  • After initial recovery from acute carbon monoxide (CO) intoxication, some patients occasionally undergo severe neuropsychiatric deterioration, which is called postanoxic delayed encephalopathy (sequelae). This is the clinical report about one patient, a 73-year-old man, diagnosed with delayed encephalopathy after acute CO intoxication. The symptoms of the patient were mental dysfunction including memory impairment and disorientation, abnormal behavior, incontinence and mutism. He had completely recovered after an aonxic episode, but the neurological symptoms that developed were preceded by an interval of apparent normality (the 'lucid interval'). We characterized him as suffering deficiency syndrome of the heart and prescribed for him Bokreongbosim-tang and Guipi-tang, and thereafter his symptoms were remarkably improved. For the evaluation of clinical improvement, we use the Modified Barthel Index (MBI), Canadian Neurologic Scale (CNS), and the Korean version of the Mini-Mental State Examination (K-MMSE)

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A Case of Thoracic Vertebral Chondroblastoma, Treated with 3-D Image Guided Resection and Reconstruction

  • Lee, Yoon-Ho;Shin, Dong-Ah;Kim, Keung-Nyun;Yoon, Do-Heum
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.154-156
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    • 2005
  • We present a case of chondroblastoma in the thoracic vertebra. A 40-year-old patient with upper back pain and lower extremity weakness was admitted to our clinic. On neurological examination, the patient exhibited lower extremity spastic paraparesis. Magnetic resonance imaging revealed a mass infiltrating the 7th thoracic vertebra and its adjacent structures with concomitant compression of the epidural space. After right upper lung tuberculoma was resected through the transthoracic approach, T7 total corpectomy was done with anterior stabilization using a MESH cage and T7 rib bone graft. Two weeks after the first operation, remained part of vertebra was removed and posterior stabilization was performed using a pedicle screw fixation and cross linkage bar with the assistance of the navigation system. The final pathologic diagnosis of the vertebral lesion was benign chondroblastoma.

A Neuro-Behçet's Case Operated with the Intracranial Mass Misdiagnosis

  • Tokgoz, Osman Serhat;Akpinar, Zehra;Guney, Figen;Seyithanoglu, Abdullah
    • Journal of Korean Neurosurgical Society
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    • v.52 no.5
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    • pp.488-490
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    • 2012
  • Behçet's disease (BD) is an inflammatory systemic disorder with oral and genital ulcers, as well as ophthalmologic and cutaneous symptoms. Neurological manifestations in BD represent between 2.2% to 50% of the cases. The 25-year-old male patient, diagnosed with BD three years earlier, was admitted to our clinic with complaints of recurrent headaches. Tumor-like-parenchimal involvement was detected on a cranial magnetic resonance imaging. The lesion was removed surgically and then he suffered from right hemiparesis and epilepsy. Pathological examination of the lesion noted a demyelinating non-tumoural etiology. A neuro-Beh$\check{g}$et's case with parenchymal involvement has been examined in light of the literature, in terms of a tumor and a demyelinating disease differential diagnosis.

Primary Extramedullary Ependymoma of the Cervical Spine : Case Report and Review of the Literature

  • Son, Dong-Wuk;Song, Geun-Sung;Han, In-Ho;Choi, Byung-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.50 no.1
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    • pp.57-59
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    • 2011
  • Intradural extramedullary (IDEM) ependymomas occur very rarely and little has been reported about their clinical characteristics. The authors present a case of a 57-year-old woman with an IDEM ependymoma. She was referred for the evaluation of a 4-month history of increasing neck pain and muscular weakness of the left extremities. Magnetic resonance imaging (MRI) of the cervical spine demonstrated an IDEM tumor with spinal cord compression. At the time of surgery, an encapsulated IDEM tumor without a dural attachment or medullary infiltration was noted, but the tumor capsule adherent to the spinal cord and root was left in place to minimize the risk of neurological sequelae. Histologic examination revealed a benign classic ependymoma. The post-operative course was uneventful and radiotherapy was performed. The patient showed an excellent clinical recovery, with no recurrence after 5 years of follow-up.

A Case of Temporal Intracerebral Hemorrhage That Presented with Sudden Bilateral Hearing Loss as the Initial Symptom

  • Mun, Seog-Kyun;Hong, Young-Ho;Kang, Suk-Hyung;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.438-440
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    • 2010
  • A 57-year-old man presented to the outpatient department with sudden bilateral hearing loss. The otological examination suggested bilateral severe sensorineural hearing loss. After several hours, the patient complained of a headache and became drowsy. The brain computed tomography showed a $3{\times}4\;cm$ intracerebral hemorrhage (ICH) of the left temporal lobe. Surgery was performed and 34 days after the procedure the patient was discharged from the hospital with severe bilateral sensorineural hearing loss (SNHL). Temporal lobe ICH should be considered in the differential diagnosis of patients with sudden bilateral hearing loss, regardless of the other neurological symptoms.

A Case of Cholecystotomy in a Dog with Cholelithiasis (개에서 담석제거를 위한 담낭절개술의 일례)

  • 구자민;황재민;김현희;이원익;손우진
    • Journal of Veterinary Clinics
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    • v.18 no.4
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    • pp.455-458
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    • 2001
  • A twelve-month old female, shih-tzu, was presented to diagnose a hind limb ataxia to the Animal Teaching Hospital, Gyeongsang National University. Even though a variety of physical and neurological examination was performed, the cause of the ataxia was not understood. In serum analysis, an elevated levels of ALT, $\gamma$-GTP and LDH were found. A gallstone was subsequently observed at the right 9 and 10th intercostal region on ultrasonography and radiography. Cholelithiasis was diagnosed, and then cholecystotomy was undertaken. No complications were occurred after the operation. The gallstone removed by cholecystotomy was composed of calcium, carbonate and oxalate, identified by a black pigment gallstone.

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Acquired myasthenia gravis in a domestic shorthair cat with cranial mediastinal mass

  • Song, Doo-Won;Kang, Min-Hee;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.56 no.2
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    • pp.121-123
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    • 2016
  • A 7-year-old castrated male domestic short-hair cat presented with anorexia, constipation, depression, and voice alteration. Physical and neurological examinations revealed hyperthermia ($40.5^{\circ}C$), ventroflexion of the neck, reduced responses to external stimuli, generalized muscle weakness, and exercise intolerance. Thoracic radiographs revealed the presence of a cranial mediastinal mass. The history, clinical signs, and other examination results were compatible with acquired myasthenia gravis (MG). Acetylcholine receptor (AChR) antibody titers were determined to confirm MG and the serum AChR antibody concentration was 1.24 nmol/L (reference interval, < 0.3 nmol/L). This is the first diagnosis of acquired MG in a cat in Korea.

Klebsiella pneumoniae infection secondary to bovine viral diarrhea in two prematurely born calves

  • Lee, Kyunghyun;Kim, Ha-Young;Choi, Eun-Jin;Lee, Kyoung-Ki;So, ByungJae;Jung, Ji-Youl
    • Korean Journal of Veterinary Research
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    • v.60 no.3
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    • pp.183-186
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    • 2020
  • This paper describes the development of neurological signs of two prematurely born calves four days after birth. The pathological examination results indicated fibrinopurulent polyserositis, including meningoencephalitis with suppurative bronchopneumonia. Bovine viral diarrhea virus subtype 2a was detected in most of the internal organs, and the bacterial colonies cultured from the samples were identified as Klebsiella (K.) pneumoniae. Molecular analysis via multilocus sequence typing identified a different K. pneumoniae isolate in each calf-type 14 in calf A and type 65 in calf B. This is the first report identifying K. pneumoniae sequence types 14 and 65 in cattle.

The Diagnosis and Ancillary Tests of Brain Death (뇌사의 진단과 진단을 위한 보조적 검사)

  • Kim, Cheon-Sik
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.1
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    • pp.64-68
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    • 2004
  • Brain death is defined as the irreversible cessation of all brain function. The diagnosis of brain death is primarily based on a careful neurological examination demonstrating unresponsiveness, absent of brain stem reflexes, and no respiratory activity. Several conditions which may mimic brain death must be excluded. In some cases investigations such as electroencephalography, angiography, transcranial doppler or evoked potentials can contribute to the diagnosis. The brief review will introduce medical technologist and clinician to the key issues in the definition and management of brain death.

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PHACE association with intracranial, oropharyngeal hemangiomas, and an atypical patent ductus arteriosus arising from the tortuous left subclavian artery in a premature infant

  • Kim, Do-Hyun;Choi, Jang-Hwan;Lee, Jung-Ha;Kim, Hee-Sup
    • Clinical and Experimental Pediatrics
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    • v.55 no.1
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    • pp.29-33
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    • 2012
  • PHACE association is a rare neurocutaneous condition in which facial hemangiomas associate with a spectrum of posterior fossa malformations, arterial cerebrovascular anomalies, cardiovascular anomalies, and eye anomalies. We reported a case of PHACE association in a premature infant showing facial, intracranial, and oropharyngeal hemangiomas with evidence of the Dandy-Walker variant and complicated cardiovascular anomalies, including a right-sided aortic arch and an atypical patent ductus arteriosus arising from a tortuous left subclavian artery. To our knowledge, intracranial hemangiomas are rare in PHACE association, and a concomitant oropharyngeal hemangioma has not been previously reported in the PHACE association literature. In infants presenting with large, plaque-like facial hemangiomas, it is important to conduct active cardiovascular and neurological evaluations. Special attention should be given to the laryngoscopic examination to search for additional hemangiomas in the airway.