• 제목/요약/키워드: Stroke, acute

검색결과 537건 처리시간 0.026초

뇌경색에 의한 편측부전마비에서 자기운동유발전위의 변동 (Change of Magnetic Motor Evoked Potentials in Hemiparesis due to Cerebral Infarction)

  • 이주호;박영혁;김광수;유경무
    • Annals of Clinical Neurophysiology
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    • 제1권2호
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    • pp.99-105
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    • 1999
  • Background and Objectives : The Motor evoked potentials (MEP) study may be useful in the evaluation of the degree of impairment in the motor nervous system and in the determination of the prognosis. The purpose of this study is to evaluate the status of central nervous system in acute and subacute state of cerebral ischemia by comparing the changes of MEP in the initial and follow-up study. Methods : Twenty patients with hemiparesis caused by ischemic stroke were recruited for this study. We tested MEP within 7 days and followed-up after 14 days after symptom onset. The cerebral motor cortex area, cervical area for upper extremity and lumbar area for lower extremity were stimulated by transmagnetic stimulator. The central motor conduction time(CMCT) was measured with the difference in MEP caused by stimulating the vertical area and spinal area. The CMCT of hemiparetic patients were classified into three groups-normal, delayed, and no evoked MEP groups. Results : The CMCT in hemiparetic side of acute ischemic stroke patients were singnificantly delayed (P < 0.05) compared with the control group. The CMCT of hemiparetic side in the follow-up study showed no sinificantly difference in comparison to the control group. The prognosis of motor improvement was better in the groups of delayed MEP than the groups of no evoked MEP. Conclusion : The CMCT of hemiparetic and contralateral sides were delayed in acute ischemic stroke, compared with control group and were returned to normal boundaries in subacute state. But in the most cases with no MEP response in the initial study, also showed no MEP response in the follow-up study. The recovery occurred in the subacute state in cases with mild hemiparesis, whereas recovery did not occur in the subacute stage in case with severe hemiparesis.

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뇌졸중 환자의 임상적 검사NIHSS(National Institutes of Health Stroke Scale)와 기능적 예후와의 상관관계 (The Relationship of NIH(National Institutes of Health) Stroke Scale to Functional Improvement in Stroke Patients)

  • 허지영;김지혁;김용권
    • 대한물리치료과학회지
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    • 제9권1호
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    • pp.103-111
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    • 2002
  • The purpose of this study was NIHSS(National Institutes of Health stroke scale) to activities of Daily Living stroke patient. We designed a 17 item neurogic Examination NIHSS use in acute stroke therapy trials. In a study of stroke patient. Assessment were measured by the NIHSS and by the MBI (Modified Barthel Index) to evaluate activities of daily living(ADL). Fifty patients were subject in this study. Collected data analysis were completed by using t-test, ANOVA, correlation analysis and Multiple regression analysis. The following were as follow; Among the test of NIHSS(National Institutes of Health stroke scale) was significantly correlated with changes in MBI(Modified Barthel Index) score in 50 stroke patients. Among the subitems of NIHSS, Pupillary Response, a level of consciousness, best motor arm, best motor leg were the best predictors of functional improvement.

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뇌경색 환자의 경동맥 초음파 검사와 한방 중풍 변증과의 관련성 연구 (Study on the Relationship between Carotid Intima-Media Thickness and Korean Standard of Pattern Identification in Ischemic Stroke Patients)

  • 김경민
    • 대한중풍순환신경학회지
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    • 제15권1호
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    • pp.29-38
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    • 2014
  • ■ Objectives The purpose of this study was to investigate the correlation of The Korean Standard Pattern Identification for Stroke and Intima-Media Thickness of common carotid artery(CCA-IMT). ■ Methods 100 subjects with acute ischemic stroke were recruited from the patients admitted to DongEui Medical Center from the June 2011 to January 2014. We assessed 100 patient's Common Carotid Intima Media Thickness data by B Mode ultrasonography. We investigated pattern identification of all subjects based on Korean Standard Pattern Identification for Stroke-III. then, We analyzed their characteristics, risk factor, blood test result, life style. ■ Results We analyzed indicators of Korean Standard Pattern Identification for Stroke-III by Common Carotid Intima Media Thickness difference. As a result, pale complexion, look powerless, drowsiness like to lie, heat vexation and aversion to heat were significantly higher in the CCAIMT ≧ 1.0mm group then in the CCA-IMT < 1.0mm group. ■ Conclusion According to the analysis, the Relationship between Carotid Intima-Media Thickness and The Korean Standard Pattern Identification for Stroke in Ischemic Stroke Patients were founded. To acquire more concrete conclusion on this theme, we need more research.

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환자 - 대조군 연구를 통한 중풍 전조증상에 대한 통계적 고찰 (A Statistical Study on Presymptoms of Stroke by Case-Control Study)

  • 김민지;강경원;유병찬;최선미;강지선;문승희;이재휘;김윤식;설인찬
    • 대한한방내과학회지
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    • 제28권4호
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    • pp.816-829
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    • 2007
  • Objectives : This study investigated warning signs and stroke presymptoms and their relationship with acute stroke patients in each stroke type. Methods : 217 patients with first-ever acute stroke within 2 weeks as the case group, 146 people without four major risk factors (hypertension, diabetes mellitus, hyperlipidemia and ischemic heart disease) as the healthy control group (Normals), and 160 people as the general control group (Controls) were recruited at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital from July 2005 to March 2007 for this case-control study. We analyzed the odds ratio of each warning sign or presymptom by multivariate logistic analysis and evaluated each stroke type, as well as general characteristics such as age, sex, etc. Results : Paralysis or weakness of the face and limbs, visual field disorder or loss of vision or blurred and double vision in eyes or both eyes, and sudden difficulty in speaking or dysarthria showed significant increase respectively in each stroke type. In contrast, numbness or tingling sensation or lowering sensation of the face and limbs, numbness or dead sensation of 1st and 2nd fingers, tension at cervical lesion, blepharospasm, facial spasm, etc. had no significant relation with stroke occurrence. Conclusions : In this study we demonstrated that each presymptom have an influence on each stroke type and have different odds ratio for stroke. We believe this may contribute to interpreting the importance of warning signs or presymptoms for each type of stroke, and more prospective studies are needed.

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Emergency Carotid Artery Stent Insertion for Acute ICA Occlusion

  • Lee, Hai-Ong;Koh, Eun-Jeong;Choi, Ha-Young
    • 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.

Short-term Coexisting Intracerebral Hemorrhage and Cerebral Infarctions

  • Song, Kwan-Su;Moon, Jae-Gon;Lee, Ho-Kook;Kim, Chang-Hyun;Hwang, Do-Yun
    • Journal of Korean Neurosurgical Society
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    • 제38권6호
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    • pp.419-424
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    • 2005
  • Objective : Short-term coexisting intracerebral hemorrhage and cerebral infarctions defined as the recurrent stroke presented with different type within three weeks. Despite the high recurrence rate of stroke, little attention and insufficient clinical data had been given to short-term coexisting intracerebral hemorrhage and cerebral infarction's features. This study aims to estimate the risk factors and present the clinical features of short-term coexisting intracerebral hemorrhage and cerebral infarctions. Methods : We investigated 18 patients with short-term coexisting intracerebral hemorrhage and cerebral infarctions who were admitted to our hospital between January 1995 and January 2005. They were subdivided by the recurrence interval such as a group of within one week and another of between one and three weeks as hyperacute and acute respectively. Results : The mean interval between strokes was 6.64 days. Lesional analysis showed that short-term coexisting intracerebral hemorrhage and cerebral infarctions in this study occurred at the other side in 12 cases [66.7%]. The abnormality on the electrocardiographic feature [23.5%] and long-term history of hypertension [20.5%] were the most common risk factors. However, short-term history of diabetes was more common in hyperacute group than in acute group [P<0.05]. The mean number of risk factors was three in acute group. It is larger than that of hyperacute group [P<0.05]. Conclusion : If the patients who experienced cerebrovascular attack have many risk factors, they tend to be the cases of acute coexisting intracerebral hemorrhage and cerebral infarctions than hyperacute. Therefore, that cases are required to be vigilant to the change of patients' state up to three weeks in the treatment.

충남에서 발생한 중증응급환자의 응급의료기관 일차 방문, 전원 및 재전원 현황 (Primary visit, transfer, and re-transfer to emergency department in patients with severe emergency diseases in Chungnam)

  • 최일국;최한주;이혜정
    • 대한응급의학회지
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    • 제29권5호
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    • pp.399-407
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    • 2018
  • Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.

중풍(中風)환자의 습담변증(濕痰辨證) 대사증후군과의 관련성 연구 (The Relation of Dampness-Phlegm and Metabolic Syndrome in Acute Stroke Patients)

  • 민인규;김창현;황재웅;박주영;이승엽;최원우;나병조;박성욱;정우상;문상관;박정미;고창남;조기호;김영석;배형섭
    • 대한한의학회지
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    • 제30권1호
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    • pp.109-119
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    • 2009
  • Objectives: This study was aimed to clarity the relationship between the pattern of dampness-phlegm and metabolic syndrome in acute stroke patients. Methods: Three hundred fifty-nine subjects were recruited from the patients admitted to the Internal Medical Department at Kyunghee University Oriental Medical Center, Donggnk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center and Kyungwon University Incheon Oriental Medical Center from April 2007 to March 2008. We diagnosed dampness-phlegm by Oriental medical diagnosis and analyzed their characteristics with type of stroke, blood test result, Sasang constitution, lifestyle and metabolic syndrome. Results: I. On the demographic variables of the patients, the weight and body mass index, the rate of hypertension, diabetes mellitus, hyperlipidemia, silent infarction were significantly higher in dampness-phlegm group than in the control. 2. There was no significant difference of stroke type between the dampness-phlegm group and the control. 3. According to the blood test, the dampness-phlegm group showed higher total cholesterol, triglyceride, fasting blood sugar and lower high density lipoprotein cholesterol than the control group with statistical significance. 4. According to the Sasang constitution distribution, the rate of Tae-Eum was significantly higher in dampness-phlegm group than in the control. 5. According to lifestyle, smoking and drinking were significantly lower in the dampness-phlegm group than in the control. Otherwise, exercise and dietary habits showed no significant difference between the two groups. 6. There were much more patients diagnosed with metabolic syndrome in the dampness-phlegm group than in the control. 7. Metabolic syndrome, silent infarction and obesity showed close relationship with dampness-phlegm pattern in multivariate analysis. Conclusions: According to the analysis, the relationship between the patterns of dampness-phlegm and metabolic syndrome in acute stroke patients were clarified. These results can be utilized in the future as a basis material.

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