• Title/Summary/Keyword: Recurrent stroke

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Study on the relation between Diabetes Mellitus during 4 Weeks after the Onset and the Score of ADL(Activity Daily Living) of Patients with Acute Cerebral Thrombosis (급성혈전성 뇌경색환자에서 당뇨군과 비당뇨군의 기능회복도에 관한 연구 - MBI, PULSES profile을 이용하여 -)

  • Koh, Kyong-Duk;Lee, Dong-Weon;Shin, Gil-Cho;Lee, Won-Chul
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.296-312
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    • 1998
  • BACKGROUND The purpose of this study was to find out predictors influencing on the clinical course of stroke during the first 4 weeks after the onset through statistical research, especially whether the blood glucose level after stroke and the stroke with Diabetes Mellitus correlate with functional impairments and neurological outcome or not. METHOD During 7 months period(from 1-1-1997 to 7-31-1997), 32 selected patients prognosed as acute cerebral thrombosis were studied by using Modified Barthel Index, PULSES profile in an attempt to correlate Diabetes Mellitus and hyperglycemia(more than $120mg/d{\ell}$, $150mg/d{\ell}$) with functional impairment and neurological outcome and to evaluate the influence of sex, the side of hemiparesis and age at admission, 1 week and 4 weeks after admision(admitted within 2 days after the onset). RESULT 1. The sex, side of hemiparesis and age had no significant effect upon functional impairment during first 4 weeks after the onset, but recurrent-stroke resulted in significantly higher degree of functional impairment than first-stroke during first 4 weeks after the onset. 2. The patients with Diabetes Mellitusin in acute cerebral thrombosis resulted in significantly higher degree of functional impairment than the patients without Diabetes Mellitus in acute cerebral thrombosis during first 4 weeks after the onset. 3. The patients with hyperglycemia in acute cerebral thrombosis resulted in significantly more severe neurological outcome than the patients without hyperglycemia in acute cerebral thrombosis within 2 days after the onset. CONCLUSION The study suggested that recurrent-stroke and Diabetes Mellitus were the poorer prognosis factors of functional impairment in acute cerebral thrombosis patients during first 4 weeks after the onset. and the poorer prognosis factor of neurological outcome in acute cerebral thrombosis patients was hyperglycemia within 2 days after the onset.

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Asymptomatic Penetration of the Oculomotor Nerve by a De Novo Aneurysm Associated with Severe Atherosclerotic Stenosis of the Supraclinoid Internal Carotid Artery

  • Shin, Hee Sup;Lee, Seung Hwan;Koh, Jun Seok
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.48-50
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    • 2014
  • A 70-year-old woman presented with headaches and recurrent stroke symptoms. During five years, the patient has been treated for cerebral infarction associated with severe atherosclerotic stenosis of the internal carotid artery. Three-year follow-up magnetic resonance angiography showed a tiny de novo aneurysm arising from the distal part of atherosclerotic internal carotid artery. And 5-year follow-up three-dimensional CT angiogram demonstrated a definite aneurysm enlargement as large as requiring treatment. During dissection of aneurysm, the oculomotor nerve was found to be penetrated with the growing de novo aneurysm. The authors report a case of a de novo aneurysm, which resulted from atherosclerotic stenosis of the internal carotid artery at the supraclinoid portion, that was found to be penetrating the oculomotor nerve with no ocular palsy.

Ischemic Stroke with Cerebral Vasculopathy in POEMS Syndrome (POEMS 증후군 환자의 뇌혈관병증에 의한 뇌졸중)

  • Kang, Sung Woo;Choi, Bo Kyu;Han, Hee Jo;Cho, Soo Mi;Cha, Jihoon;Nam, Hyo Suk;Heo, Ji Hoe;Kim, Young Dae
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.350-353
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    • 2018
  • Ischemic stroke caused by the cerebral vasculopathy is a rare complication of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. We present a case of recurrent ischemic strokes caused by cerebral vasculopathy in a patient with POEMS syndrome. A 34-year-old man presented with gait disturbance and dizziness. Brain magnetic resonance imaging demonstrated acute ischemic stroke in the middle cerebral artery-anterior cerebral artery (MCA-ACA) border zones of bilateral hemispheres. Repeated angiographic studies showed progressive worsening of the left distal internal carotid artery, ACA, and MCA stenoses, along with sustained steno-occlusion of right MCA.

A Case of Treating Chest Pain Associated with Myocardial Bridge (흉통(胸痛)이 있는 심근교(myocardial bridge) 환자의 치험 1례)

  • Kim, Bo-ram;Choi, Dong-jun;Lim, Sung-woo
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.74-80
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    • 2009
  • Myocardial bridging, a congenital coronary anomaly, is present when a segment of a major epicardial coronary artery, runs intramurally through the myocardium. So with each systole, the coronary artery is compressed. It has been associated with angina, arrhythmia, myocardial infarction and sudden cardiac death. This is a case of a 39-year-old woman who was diagnosed myocardial bridge. She complained of recurrent chest pain, palpitation. We diagnosed her as Gyesimtong(JiXiTong, 悸心痛), and prescribed Jeongkicheonhyang-tang(正氣天香湯). After treatment, all of the symptoms had improved and have not recurred for 18 months. This case suggests that oriental medicine therapy can be applicable to improve in symptoms of myocardial bridge.

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Spontaneous Conversion of Atrial Fibrillation to Normal Sinus Rhythm Following Recurrent Cerebral Infarctions

  • Oh, Kyungmi;Choi, Jeong-Yoon;Kim, Byung-Jo
    • Journal of Korean Neurosurgical Society
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    • v.53 no.6
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    • pp.368-370
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    • 2013
  • Post-stroke atrial fibrillation has been frequently reported especially in the patients with right insular infarct as an evidence of cerebrogenic mechanism affecting on cardiac rhythm. However, conversion to normal sinus rhythm after stroke in patients who had atrial fibrillation has not been reported. A 88-year-old men who had untreated atrial fibrillation was admitted to hospital due to left middle cerebral artery territory infarction. During admission, second ischemic attack occurred in right middle cerebral artery territory. At that time, his atrial fibrillation converted spontaneously to normal sinus rhythm. Restored sinus rhythm sustained until he died due to sepsis. This case is evidence supporting a theory that brain is associated with control of cardiac rhythm. If no risk factor is revealed by intensive investigation in patients with acute cerebral infarctions that cardioembolism is strongly suspected as a cause, physicians should concern transformation of atrial fibrillation to normal sinus rhythm after stroke.

Activity recognition of stroke-affected people using wearable sensor

  • Anusha David;Rajavel Ramadoss;Amutha Ramachandran;Shoba Sivapatham
    • ETRI Journal
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    • v.45 no.6
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    • pp.1079-1089
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    • 2023
  • Stroke is one of the leading causes of long-term disability worldwide, placing huge burdens on individuals and society. Further, automatic human activity recognition is a challenging task that is vital to the future of healthcare and physical therapy. Using a baseline long short-term memory recurrent neural network, this study provides a novel dataset of stretching, upward stretching, flinging motions, hand-to-mouth movements, swiping gestures, and pouring motions for improved model training and testing of stroke-affected patients. A MATLAB application is used to output textual and audible prediction results. A wearable sensor with a triaxial accelerometer is used to collect preprocessed real-time data. The model is trained with features extracted from the actual patient to recognize new actions, and the recognition accuracy provided by multiple datasets is compared based on the same baseline model. When training and testing using the new dataset, the baseline model shows recognition accuracy that is 11% higher than the Activity Daily Living dataset, 22% higher than the Activity Recognition Single Chest-Mounted Accelerometer dataset, and 10% higher than another real-world dataset.

Ischemic Stroke in a Patient with Heterozygote Fabry's Disease (보인자 파브리병 환자에서 발생한 허혈뇌졸중)

  • Yang, Sun Woo;Choi, Jay Chol;Kim, Hyun Woo;Jeong, Jin-Ho;Hyun, Chang-Lim;Koh, Myeong Ju
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.341-344
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    • 2018
  • It is uncommon for Fabry's disease (FD) patient to present with an isolated ischemic stroke without other typical symptoms or signs of FD. A 48-year-old woman presented with recurrent limb weakness and her brain magnetic resonance imaging revealed multiple ischemic brain lesions. Ten years ago, the patient had been diagnosed with heterozygote FD by the genetic test, but she had not shown any typical symptoms or sign of FD so far. Isolated organ involvement could occur in heterozygote FD.

Importance of CADASIL research in Jeju: a review and update on epidemiology, diagnosis, and clinical spectrum (제주도에서 CADASIL 연구의 중요성: 역학, 진단 및 임상양상에 대한 고찰)

  • Choi, Jay Chol;Lee, Jung Seok;Kim, Kitae
    • Journal of Medicine and Life Science
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    • v.17 no.3
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    • pp.65-73
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    • 2020
  • Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a single-gene disease of the cerebral small blood vessels caused by mutations in the NOTCH3 gene on chromosome 19. Although CADASIL was known as a rare disease, recent research has suggested that the NOTCH variants could be found frequently even in the general population. The main clinical features included recurrent stroke, migraine, psychiatric symptoms, and progressive cognitive decline. On brain magnetic resonance imaging, patients with CADASIL showed multifocal white matter hyperintensity lesions, lacunar infarcts, microbleeds, and brain atrophy. Among them, lacunar infarcts and brain atrophy are important in predicting the clinical outcomes of patients with CADASIL. In the Jeju National University Hospital, we have diagnosed 213 CADASIL patients from 2004 to 2020. Most NOTCH3 mutations were located in exon 11 (94.4%), and p.Arg544Cys was the most common mutation. The mean age at diagnosis was 61.0±12.8 years. The most common presenting symptoms were ischemic stroke (24.4%), followed by cognitive impairment(15.0%), headache (8.9%), and dizziness(8.0%). Although the exact prevalence of CADASIL in Jeju is still unknown, the disease prevalence could be as high as 1% of the population considering the prevalence reported in Taiwan. Therefore, it is necessary to discover efficient biomarkers and genetic tests that can accurately screen and diagnose patients suspected of having CADASIL in this region. Ultimately, it is urgent to explore the exact pathogenesis of the disease to identify leading substances of treatment potential, and for this, multi-disciplinary research through active support from the Jeju provincial government as well as the national government is essential.

A Case Report of MELAS Syndrom (MELAS Syndrome 환아(患兒) 1예(例)에 대한 고찰(考察))

  • Jeong Hwan-Su;Lee Jin-Yong;Kim Deok-Gon
    • The Journal of Pediatrics of Korean Medicine
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    • v.13 no.2
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    • pp.225-235
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    • 1999
  • MELAS is the condition associated with mutant mtDNA that most closely mimics thrombotic cerebrovascular disease. Characteristic abnormalities are two. first, 'ragged-red fibers' in muscle biopsy. second, point mutation in the mitochondrial DNA analyses. The characteristic clinical presentations of MELAS are short stature, recurrent stroke like episodes, migraine-like headache, sensorineural hearng loss, glucose intolerance and neuropathy. We now report a case of MELAS syndrome having mitochondrial DNA mutation with an A to G transition at the 3,243rd position diagnosed in Chung-ang Hospital.

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Floating Thrombus in the Ascending Aorta of the Patient with Systemic Sclerosis - A case report -

  • Lee, Sub;Cho, Jun-Woo;Kwon, Oh-Choon
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.72-75
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    • 2011
  • Aortic thrombi are important because it can cause the central and peripheral embolizations. Aortic thrombi can occur anywhere in the aorta but extremely rare in ascending aorta without atherosclerosis, aneurysm, cardiosurgical or traumatic state. Systemic sclerosis (SSc) is an autoimmune disorder of connective tissue and it can involve multisystem. Enhanced coagulation pathways, decreased fibrinolysis, and endothelial dysfunction probably contribute to vascular events in SSc. We report a case of a highly mobile thrombus in the ascending aorta, presented as an acute embolic stroke in the patient with systemic sclerosis. Surgical removal was performed to prevent recurrent embolic events.