• Title/Summary/Keyword: Stroke recurrence

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Yearly Report on CVA Patients (뇌졸중 환자에 대한 연례보고(2004년))

  • Park, Jung-sup;Jung, Seung-min;Lee, Si-hyung;Jung, Ki-yong;Yeo, Hyun-soo;Hsia, Yu-chun;Choi, You-kyung;Jun, Chan-yong;Kim, Dong-woo;Park, Chong-hyeong
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.7 no.1
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    • pp.23-33
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    • 2006
  • Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 102 patients who were admitted to Department of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2004 to Dec. 31, 2004. Results : Ischemic stroke(include TIA, 82.4%) was more common than hemorrhagic stroke(17.6%). The incidence in male was 41.2%, in female was 17.6% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in lacunar-infarction and hemorrhage in putamen. Hypertention, the most preceding diseases, followed by diabetes mellitus and CVA. The rate of recurrence was 27.45%. Cerebral infarction and cerebral hemorrhage was much occurred after rising. The most patients visited the hospital within 24 Hours. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly mental disorder. Conclusion : Our study on CVA patients was similar to previous studies from 1994 to 2003. In most cases, western and oriental treatment and medicine were given synthetically.

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A Clinical Study on Stroke patients(CVA) in Seosan province (서산 지역에서의 중풍에 대한 임상적 고찰)

  • Lee, Geun-Dong;Seo, Jong-Eun;Han, Sung-Soo
    • The Journal of Internal Korean Medicine
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    • v.21 no.5
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    • pp.715-721
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    • 2000
  • Objective : The purpose of this study is about stroke patients in Seosan. Method : The subjects of this study were 45 patients who were admitted to Hanseo University Oriental Hospital because of stroke. Each patients was diagnosed with Brain CT, sasang constitutional analysis. Results : 1. The rates in CVA was 58% on cerebral infarction, and 42% on cerebral hemorrhage. 2. The sites of cerebral infarction were Basal ganglia, MCA, Internal. External capsule. Thalamus, ect. Sites of cerebral hemorrhage were Thalamus, Basal ganglia, Cerebellum. 3. The ratio of left and right hemiplegia in cerebral infarction was 1:1.6, and in cerebral hemorrhage it was 1:2. 4. The most chief complaints in cerebral infarction, were hemiplegia, dysarthria, facial palsy, headache. In cerebral hemorrhage, their were hemiplegia, dysarthria, headache, dizziness, and facial palsy. 5. Classification of human corporal constitution in cerebral hemorrhage, the most was Taeumin, Soyangin, Soeumin. And in cerebral infarction, the most was Soyangin, Taeumin, Soyumin. 6. The ratio between male and female was 1.25:2 in cerebral hemorrhage, 2.5:5 in cerebral infarction. 7. The most prevalent age groups in cerebral hemorrhage was fifties to sixties. and in cerebral infarction was fifties to sixties. 8. The most common preceding disease in cerebral hemorrhage was HTN, DM. 9. The recurrence rate of cerebral hemorrhage was 16%, and cerebral infarction was 8%. 10. The ratio of recovery in cerebral hemorrhage was 84%, in cerebral infarction 58%. Conclusion : From this study, in cerebral hemorrhage most patients were Taeumin, in their fifties to sixties. And in cerebral infarction most patients were Soyangin, in their sixties to eighties. In both stroke patients, there were more female than male patients.

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Unusual paradoxical embolic stroke in a patient with persistent left superior vena cava (지속성 좌측 상대정맥 환자에서 발생한 드문 색전성 뇌졸중)

  • Kwon, Tae-hun;Choi, Kang-un;Kim, Byung-jun;Cho, Jae-ho;Lee, Jae-young;Park, Kyu-hwan;Lee, Sang-hee;Son, Jang-won
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.118-121
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    • 2015
  • Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high. Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler. A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus. Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt. We report on a 78-year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.

The Hematologic Study as risk factors on premature examination of stroke (PES) (중풍위험인자로서의 혈액학적 소견 연구 - 중풍조기검진 326명에 대한 분석 -)

  • Han, Deok-hee;Seol, In-chan;Kim, Yoon-sik
    • Journal of Haehwa Medicine
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    • v.13 no.2
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    • pp.221-229
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    • 2004
  • 1.Purpose Stroke is the most frequent cause of mortality and morbidity rate in Korea with ischemic heart disease and cancer. Recent recurrence rate of stroke is high, but little attention had been given to the features of its' cause. The purpose of this studies is to examine the hematologic states in Korean normal adults through premature-examination of stroke(PES). 2.Method The study group consisted of 326 cases that they had no significant results by CT through premature examination of stroke(PES) in Cheonan oriental hospital of Daejeon university. We tested RBC, hemoglobin, hematocrit, WBC, PT, PTT, PLT, total protein, albumin, total bilirubin, direct bilirubin, GOT, GPT, $\gamma$-GTP, total cholesterol, triglyceride, HDL-C, glucose, BUN, creatinine, Na, K and evaluated by cross sectional study. 3.Result In the PES, there were many patients with low RBC(11%), shorten PT(26.7%), delayed PTT(19.3%), high TP, GPT, ${\gamma}$ -GTP(respective1y 16.9%, 14.4%, 13.5%), high cholesterol level and triglyceride level(respectively 18.7%, 28.2%). We didn't found significant cases in hemoglobin, hematocrit, WBC, PLT, albumin, total bilirubin, direct bilirubin, GOT, HDL-C, glucose, BUN, creatinine, Na, K. 4.Conclusion In this study, we demonstrated that short PT, high triglyceride level are special views in PES. Also prospective studies are needed continuously to search the preventing methods of the CVA.

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Clinical Study on Unexpected Death in Stroke Patients (한방 병원에서 발생한 중풍으로 인한 예상치 못한 사망에 관한 고찰)

  • Seo, Dong-Min;Woo, Hyun-Su;Lee, Hyun-Jong;Kim, Jong-Deog;Hong, Jang-Mu;Kang, Mi-Kyeong;Seo, Byung-Kwan;Kim, Dong-Hon;Cho, Young;Lee, Sang-Hoon;Kim, Chang-Hwan
    • The Journal of Korean Medicine
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    • v.24 no.3
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    • pp.165-171
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    • 2003
  • Objective : Stroke is the second major cause of death in Korea. It is known that the survival and ultimate outcome in stroke depend on various factors, so it is not easy to predict unexpected death in stroke. This study was performed in order to find predicting factors of unexpected death in stroke. Methods : A retrospective study was accomplished by reviewing 21 medical records of stroke patients who expired in the ward of Kyung Hee Oriental Medical Center from January 1998 to December 2001. Data analyzed Were physical examination, laboratory findings, clinical charts and APACH III scoring system. Results : I. The number of unexpected deaths at the ward of Kyung Hee Oriental Medical Center from January in 1998 to December in 2001 were 21 patients (0.1%). 2. Major risk factors of unexpected death were age (${\geq}60$), high blood pressure on 1st admission day and acute stage (${\leq}30{\;}days$). 3. The most frequent time of unexpected death was from 6 a.m. to noon. 4. Major cause of unexpected death was recurrence of stroke (40%). 5. APACH III scores of 75% of unexpected death patients were over 30 points. 6. Clinical change of symptoms 3 or 4 days before the unexpected death were dyspnea, change of urination and defecation. Conclusion; This mortality study suggests that old age, high blood pressure on 1st admission day, acute stage, and high APACH III score are the major predictors of unexpected death in stroke patients and that intensive medical attention is necessary to reach a better outcome.

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Surgical Outcomes of Cardiac Myxoma Resection Through Right Mini-Thoracotomy

  • Changwon Shin;Min Ho Ju;Chee-Hoon Lee;Mi Hee Lim;Hyung Gon Je
    • Journal of Chest Surgery
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    • v.56 no.1
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    • pp.42-48
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    • 2023
  • Background: With recent advances in cardiac surgery through minimal access, mini-thoracotomy has emerged as an excellent alternative for cardiac myxoma resection. This study analyzed the surgical results of this approach, focusing on postoperative cerebral embolism and tumor recurrence. Methods: We retrospectively reviewed 64 patients (mean age, 56.0±12.1 years; 40 women) who underwent myxoma resection through mini-thoracotomy from October 2008 to July 2020. We conducted femoral cannulation and antegrade cardioplegic arrest in all patients. Patient characteristics and perioperative data, including brain diffusion-weighted magnetic resonance imaging (DWI) findings, were collected. Medium-term echocardiographic follow-up was performed. Results: Thirteen patients (20.3%) had a history of preoperative stroke, and 7 (11.7%) had dyspnea with New York Heart Association functional class III or IV. Sixty-one cases (95.3%) had myxomas in the left atrium. The mean cardiopulmonary bypass and cardiac ischemic times were 69.0±28.6 and 34.1±15.0 minutes, respectively. Sternotomy conversion was not performed in any case, and 50 patients (78.1%) were extubated in the operating room. No early mortality or postoperative clinical stroke occurred. Postoperative DWI was performed in 32 (53%) patients, and 7 (22%) showed silent cerebral embolisms. One patient underwent reoperation for tumor recurrence during the study period; in that patient, a genetic study confirmed the Carney complex. Conclusion: Mini-thoracotomy for cardiac myxoma resection showed acceptable clinical and neurological outcomes. In the medium-term echocardiographic follow-up, reliable resection was proven, with few recurrences. This approach is a promising alternative for cardiac myxoma resection.

Functional Insufficiency of Mitral and Tricuspid Valves Associated With Atrial Fibrillation: Impact of Postoperative Atrial Fibrillation Recurrence on Surgical Outcomes

  • Kitae Kim;Jin Kim;Sung-Ho Jung;JaeWon Lee;Joon Bum Kim
    • Korean Circulation Journal
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    • v.53 no.8
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    • pp.550-562
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    • 2023
  • Background and Objectives: To identify the factors associated with adverse outcomes following surgery for functional insufficiency of the mitral valve (MV) or tricuspid valve (TV) associated with atrial fibrillation (AF). Methods: We evaluated 100 patients (age, 66.5±10.0 years; 47 males) who consecutively underwent surgery for functional insufficiency of the MV or TV associated with AF between January 2000 and December 2020 at our center. The primary outcome was a composite endpoint of all-cause death, valve reoperation, congestive heart failure (CHF) requiring rehospitalization, and stroke. Results: During follow-up (532 patients-years [PYs]), adverse events included death in 16 (3.0%/yr), MV reoperation in 1 (0.2%/yr), CHF in 14 (2.6%/yr), and stroke in 5 (0.9%/yr) patients, demonstrating a 5-year rate of freedom from the primary endpoint of 69.5%. The rate of postoperative AF was high even in those who underwent AF ablation (n=92), with cumulative rates of 48.1% at 1 year and 60.2% at 5 years. In multivariable analyses, the primary outcome was significantly associated with age (adjusted hazard ratio [aHR], 1.06; 95% confidence interval [CI], 1.02-1.10; p=0.005), chronic kidney disease (aHR, 7.76; 95% CI, 2.28-26.38; p=0.001), left atrial appendage exclusion (aHR, 0.35; 95% CI, 0.16-1.78; p=0.010), and postoperative AF as a time-varying covariate (aHR, 3.33; 95% CI, 1.50-7.40; p=0.003). Conclusion: Among patients undergoing surgery for functional atrioventricular insufficiency associated with AF, a significant proportion showed recurrence of AF over time after concomitant AF ablation, which was significantly associated with poor clinical outcomes.

A Case Report of One Patient with Paralytic Strabismus Resulting from Pontine Hematoma During Puerperium (산욕기에 발생한 뇌교출혈로 인한 마비성 사시 환자 치험 1례)

  • Kim, Yu-Kyung;Kim, Woo-Sung;Kang, Sei-Young;Sim, Kuk-Jin;Yoon, Ji-Won;Baek, Dong-Gi;Lee, Jong-Deok;Won, Jin-Hee;Lee, Sang-Kwan;Kim, Hong-Joon
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.640-647
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    • 2004
  • Pregnancy related stroke is significant because it has dire impact on both mother and the fetus. Pregnant or puerperal women are reported to have about 13-fold more risk of stroke compared to non-pregnant women. Pregnancy-related stroke must be differentiated from stroke in elderly patients, because it is different in pathophysiological etiologies and recurrence rates and also diagnostic and therapeutic methods may affect the fetal health status. Because the VI cranial nerve manages lateral rectus muscles, it' s palsy causes sudden onset of double vision. The eyes turn medially. In this article, one case of paralytic strabismus resulting from pontine hematoma during puerperium is reported. It was treated with herb medicine and acupuncture. Symptoms improved. This case is submitted with a brief overview of related lit.

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The survey about the recognition and demand on cooperative system between western and oriental medicine of stroke patients in National Rehabilitation Center (국립재활원 뇌졸중 환자의 협진에 대한 인식 및 수요 조사 연구)

  • Lim, Sung-Min;Song, Sung-Eun
    • Journal of Society of Preventive Korean Medicine
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    • v.15 no.1
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    • pp.131-143
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    • 2011
  • Objective : The purpose of this study was survey about the recognition and demand on cooperative system between western and oriental medicine of stroke patients in National Rehabilitation Center. Methods : The participants were 205 stroke patients in the National Rehabilitation Center and investigated the recognition and demand on cooperative system between western and oriental medicine. Results : As to general characteristics of the group, 56.9% were male, 30.7% were in the 60~69 age, 24.3% of patients had an average income per month 1.0~2.0 million. In regard to disease status of patients, 53.8% were cerebral infarction, 35.8% were below 6 month in disease duration, 73.7% were none recurrence, 52.8% were hypertension as related disease, 74.5% were motor paralysis sequela. 83.2% were positive response in using oriental medicine department of National Rehabilitation Center. The most wanted therapy was acupuncture. Most of respondents expected that co-operative treatments were to be improving the cure effect for patients. And they wanted cooperative system combined evenly between western and oriental medicine, so the western doctors and the oriental doctors suggest the plan giving lots of medial benefits for patients. Conclusion : This survey showed the recognition and demand on cooperative system between western and oriental medicine of patients in National Rehabilitation Center. It is possible to realize patient's centered treatment under the stable and efficient cooperation of western and oriental medicine.

Clinical characteristics and outcomes in patients with lesion-positive transient ischemic attack

  • Kang, Su-Jeong;Lee, Sang-Gil;Yum, Kyu Sun;Kim, Ji-Seon;Lee, Sung-Hyun;Lee, Sang-Soo;Shin, Dong-Ick
    • Journal of Biomedical and Translational Research
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    • v.19 no.4
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    • pp.110-115
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    • 2018
  • Transient ischemic attack (TIA) indicates high risk for major stroke and is considered a medical emergency. Diffusion-weighted imaging (DWI) enables detection of acute ischemic lesions. The clinical significance of DWI positive lesions in TIA is obscure and its prevalence, clinical features are not established. Therefore, we performed a clinical, etiological and prognostic analysis through a cross-sectional analysis of 235 TIA patients, grouped according to presence of DWI lesion. Clinical features, underlying risk factors for stroke, outcome and rate of recurrence were analyzed. 3 months follow-up of modified Rankin Scales (mRS) were done with telephone survey. DWI positive lesions were present in 14.0% of patients. Etiological factors significantly associated with DWI lesions in TIA patients were male sex (p = 0.038), stroke history (p = 0.012) and atrial fibrillation (p < 0.001). Presence of at least one medium or high risk of cardioembolism from TOAST classification were not associated with lesions when excluding association to atrial fibrillation (p = 0.108). Clinical features showed no significant difference. Whether the patients had lesion-positive DWI was not related to an increase in mRS score during the hospital stay or at the 3-month follow-up after discharge. Future studies should include multi-center samples with large numbers, considering each unique medical environment. Routine acquisition of follow-up DWI for proper evaluation of the tissue-based definition of TIA should also be considered.