• 제목/요약/키워드: Old patient

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척추 암전이 환자에서 미추마취후 발생한 마미증후군 -증례 보고- (Cauda Equina Syndrome following Caudal Anesthesia in a Patient with Metastatic Spine Tumor -A case report-)

  • 이준학;박성희;이기남;문준일
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.134-137
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    • 1997
  • We report a case of cauda equine syndrome following caudal anesthesia possibly caused by metastatic spine tumor. Male, 80-year-old, who had prostatic carcinoma with $L_3$ and $L_4$ spine metastasis was scheduled for bilateral orchiectomy. Twenty two-gauge needle was introduced at sacral hiatus and 15 ml of 2% lidocaine administered. The next morning, patient complained of perineal numbness and urination difficulty. During the next several day patient had episodes of fecal incontinence and motor weakness on both lower extremities. This case reminded us that neuroaxial blocks such as spinal, epidural and caudal anesthesia, should be used with extreme care in patients having neoplasm with high incidence of spine metastasis.

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대상포진후 신경통 치료를 위한 지속적 경막외 차단후 발생한 경막외 혈종 -증례 보고- (Epidural Hematoma following Continuous Epidural Catheterization for Postherpetic Neuralgia -A case report-)

  • 조동규;이강창;김태요
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.127-130
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    • 1997
  • A 67-year old man with a history of cardiac disease underwent epidural catheterization for pain control of postherpetic neuralgia. Patient had severe back pain and pus discharge at catheter insertion site after dischange from medical part. Patient received anticoagulant therapy with $Aspirin^{(R)}$ and $Coumadin^{(R)}$ prescribed for 15 days in medical part. Magnetic resonance imaging(MRI) showed a diffuse $T_{4-7}$ anterior epidural mass compressing the spinal cord. Emergency surgical exploration revealed a thoracic epidural hematoma without abcess formation. Operation was successful and patient recovered satisfactory without any sequelae.

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간질 발작이 병발한 파킨슨 환자 1례 (The clinical study on 1 case of Parkinson's disease patient with seizure)

  • 임현주;최강욱;정인철;이상룡
    • 동의신경정신과학회지
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    • 제18권3호
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    • pp.165-180
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    • 2007
  • Parkinson's disease is a common neurodegenerative disorder charaterized by distal resting tremor, rigidity, and bradykinesia, and asymmetric onset. The patient was 38-year-old man who had Parkinson's disease diagnosed and complained resting and postural tremor, rigidity, bradykinesia and so on. He was treated by oriental medicine with acupuncture, herb medication, physical therapy, kinesitherapy and Korean psychotherapy; Eejeong-byunki, Jiun-goron. After treatment the symptoms of Parkinson' disease was reduced, but the patient was deconditioned through several seizures. This result suggested that the oriental medical therapy is recommanded for Parkinson's disease. But, the relation of Parkinson's disease and seizure should be studied.

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Glioblastoma Mimicking Herpes Simplex Encephalitis

  • Nam, Tai-Seung;Choi, Kang-Ho;Kim, Myeong-Kyu;Cho, Ki-Hyun
    • Journal of Korean Neurosurgical Society
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    • 제50권2호
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    • pp.119-122
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    • 2011
  • We report a case of 70-year-old man with glioblastoma presenting as acute encephalitic illness. The patient exhibited sudden onset of cognitive impairment and headache for 2 days. Initial brain MRI showed left temporal lobe hyperintensity, and cerebrospinal fluid cytology revealed a mild pleocytosis. The patient had initially improved after medical treatment with a presumptive diagnosis of herpes simplex encephalitis (HSE). After 8 months, the patient complained of recurrent seizures. A follow-up brain MRI revealed marked increases in size and surrounding perilesional edema in the left temporal lesion on T2-weighted images and a new contrast-enhancing lesion on gadolinium-enhanced T1-weighted images. Stereotactic brain biopsy revealed a glioblastoma. The atypical encephalitic presentation of glioblastoma should be considered if definitive evidence for the diagnosis of HSE cannot be obtained.

Spontaneous Spinal Subarachnoid Hemorrhage with Spontaneous Resolution

  • Kim, Jin-Sung;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • 제45권4호
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    • pp.253-255
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    • 2009
  • Spontaneous spinal subarachnoid hematoma (SSH) is a rare entity to cause spinal cord or nerve root compression and is usually managed as surgical emergencies. We report a case of spontaneous SSH manifesting as severe lumbago, which demonstrated nearly complete clinical resolution with conservative treatment A 58-year-old female patient developed a large SSH, which was not related to blood dyscrasia, anticoagulation, lumbar puncture. or trauma. Patient had severe lumbago but no neurologic deficits. Because of absence of neurologic deficits, she was treated conservatively. Follow-up magnetic resonance (MR) image showed complete resolution. Conservative treatment of SSH may be considered if the patient with spontaneous SSH has no neurologic deficits.

Atypical Guillain-Barr$\acute{e}$ Syndrome Misdiagnosed as Lumbar Spinal Stenosis

  • Jung, Dae Young;Cho, Keun-Tae;Lee, Seung Chul
    • Journal of Korean Neurosurgical Society
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    • 제53권4호
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    • pp.245-248
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    • 2013
  • Guillain-Barr$\acute{e}$ syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.

Multiple Spinal Revision Surgery in a Patient with Parkinson's Disease

  • Malla, Hridayesh Pratap;Kim, Min Ki;Kim, Tae Sung;Jo, Dae Jean
    • Journal of Korean Neurosurgical Society
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    • 제59권6호
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    • pp.655-658
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    • 2016
  • Parkinson's disease (PD) patients frequently have several spinal deformities leading to postural instabilities including camptocormia, myopathy-induced postural deformity, Pisa syndrome, and progressive degeneration, all of which adversely affect daily life activities. To improve these postural deformities and relieve the related neurologic symptoms, patients often undergo spinal instrumentation surgery. Due to progressive degenerative changes related to PD itself and other complicating factors, patients and surgeons are faced with instrument failure-related complications, which can ultimately result in multiple revision surgeries yielding various postoperative complications and morbidities. Here, we report a representative case of a 70-year-old PD patient with flat back syndrome who had undergone several revision surgeries, including anterior and posterior decompression and fusion for a lumbosacral spinal deformity. The patient ultimately benefitted from a relatively short segment fixation and corrective fusion surgery.

안검하수(眼瞼下垂)를 동반한 화병(火病) 환자 치험 1례 (A Case Report on Hwabyung Patient with Blepharoptosis)

  • 황정현;김지훈;구병수;김근우
    • 동의신경정신과학회지
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    • 제20권4호
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    • pp.161-172
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    • 2009
  • Objectives : This study was designed to research the effect of oriental treatments for Hwabyung with Blepharoptosis. Methods : A 51 year-old female patient has been suffered by Hwabyung for 5 months and by Blepharoptosis for 2 weeks. We treated the patient with Herbal medication, oriental psychotherapy and acupuncture. Results : As a result of oriental treatments, Blepharoptosis was disappeared, and the symptoms of Hwabyung was improved gradually. Conclusions : These result suggest that oriental treatments have an effect on Hwabyung with Blepharoptosis.

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Behavioral and Psychological Symptoms of Dementia Treated with Korean Medicine: A Case Report

  • Song, Sue-jin;Sung, Yung-wei;Koo, Byung-soo
    • 동의신경정신과학회지
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    • 제28권4호
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    • pp.391-399
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    • 2017
  • Objectives: To determine the effects of Korean medicine on behavioral and psychological symptoms of dementia (BPSD) of an Alzheimer's disease (AD) patient. Methods: A 85-year old female patient diagnosed with AD was treated with herbal medicine formula Chungsimyeonja-tang (淸心蓮子湯), Woohwangchungsim-won (牛黃淸心元), and acupuncture. Korean version of Mini-mental State Examination (MMSE-K) scores were used at baseline and post treatment as outcome measures to evaluate clinical symptoms of the patient. Results: Improvements in MMSE-K post treatment scores were observed compare to those at baseline. BPSD were also alleviated. Such changes were visually noticeable. Conclusions: Herbal medicine and acupuncture treatment were effective in alleviating symptoms of AD. Further studies with a larger sample size and randomized clinical trials are needed to obtain more reliable and valid treatment outcomes.

외상성 심장파열의 외과적 고찰 (Traumatic Cardiac Perforation)

  • 성시찬
    • Journal of Chest Surgery
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    • 제12권4호
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    • pp.365-370
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    • 1979
  • The first Mitral Commissurotomy was performed for tight mitral stenosis on March 1957. The patient was at that time 22-year-old male, student. The longest follow 9p for 22 years and 8 months has been obtained. During the follow up period, late deterioration due to restenosis developed 4 years after initial good result and reoperation was succeeded by transventricular Mitral Valvotomy with Tubb`s ilator on April 1964. The possible cause of restenosis was attributed to recurrent rheumatic activity. After more than 13 years long-good life following 2nd operation, Endocarditis such as episode of high fever & chill intermittently followed by mild fever and night sweat, I t. tibial artery embolization and rupture of aortic cusp. At present, patient complained of no subjective symptom, enjoying ordinary life {NYHA II]. Blood pressure has been 110/50-60 mmHg, trivial diastolic murmur at apex and moderate degree of mechanical murmur on diastole at Erb`s rea. Neither signs of RVH for mitral stenosis nor sign of LVH. ST-T change for aortic regurgitation appeared yet during last 2 yrs. The patient`s are for prevention of Rheumatic activity and development of endocarditis is important for obtaining the better long-term result.

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