• 대한신경과학회지
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• 제36권4호
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• pp.314-317
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• 2018

Focal subarachnoid hemorrhage occasionally presents as transient focal neurologic episodes mimicking transient ischemic attack (TIA). Unless properly diagnosed, it may aggravate cerebral hemorrhage by administering antithrombotic agents. Therefore, clinicians need to be aware that such focal subarachnoid hemorrhage sometimes cannot be detected on noncontrast computed tomography and blood-sensitive magnetic resonance imaging can detect even a small amount of hemorrhage. We describe an 85-year-old woman with focal subarachnoid hemorrhage and possible cerebral amyloid angiopathy who presented transient left arm weakness recurrently, which mimicked TIA.

• 대한임상검사과학회지
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• 제47권1호
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• pp.24-27
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• 2015

To measure motor evoked potentials (MEP) during emergency surgery is often difficult in patients with subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm, The cause of these difficulties may be considered as damage to the motor pathway by hemorrhage. To identify the cause of difficulties in measuring MEP, we defined the association between motor evoked potentials during surgery and the severity of the hemorrhage in patients with subarachnoid hemorrhage.

• Journal of Korean Neurosurgical Society
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• 제59권1호
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• pp.62-64
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• 2016

Cerebrospinal fluid leakage may commonly occur during spinal surgeries and it may cause dural tears. These tears may result in hemorrhage in the entire compartments of the brain. Most common site of such hemorrhages are the veins in the cerebellar region. We report a case of hemorrhage, mimicking aneurysmal subarachnoid hemorrhage due to a cerebrospinal fluid leakage following lumbar spinal surgery and discuss the possible mechanisms of action.

• Annals of Clinical Neurophysiology
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• 제1권1호
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• pp.55-59
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• 1999

Vasoconstriction of intracerebral arteries is the leading cause of delayed cerebral infarction and mortality following aneurysmal subarachnoid hemorrhage. Transcranial Doppler studies show and increase in the flow velocities of basal cerebral arteries, which usually start around day 4 following a subarachnoid hemorrhage, and peaking by days 7 to 14. Angiographic studies confirm the presence of at least some degree of MCA vasospasm when the flow velocities are higher than 100 cm/sec. Mean velocities in the 120 to 200 cm/sec range correspond to 25 to 50% luminal narrowing. MCA and ACA vsospasm is detected with around 90% specificity. Sensitivity is 80% and 50% respectively. A 200cm/sec threshold and rapid flow velocity increase exceeding 50 cm/sec on consecutive days, has been associated with subsequent infarction. Transcranial Doppler is also used to monitor the effects of endovascular treatment of vasospasm. Flow velocities decrease following successful angioplasty or papaverine infusion. Overall, transcranial Doppler studies are considered to have acceptable accuracy for the evaluation of vasospasm in aneurysmal subarachnoid hemorrhage, with limitations that have to be taken into consideration in the clinical setting.

• The Korean Journal of Pain
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• 제10권1호
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• pp.121-123
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• 1997

Stellate ganglion block(SGB) is frequently performed to relieve a patient from headache of various. We experienced a rare case of subarachnoid hemorrhage by aneurysmal rupture after SGB. A 46-year-old female patient diagnosed with tension headache, and normal MRI finding consulted our pain clinic. We performed right SGB in combination with greater occipital nerve block. The next day, we performed left SGB with 6 ml of 0.25% bupivacaine. She had no evidence of subarachnoid block or intravascular injection. 15 minutes after injection, she abruptly developed convulsion and loss of consciousness. She was given artificial respiration with oxygen. The diagnosis of ruptured left posterior communicating aneurysm was confirmed by 4-vessels angiography.

• The Korean Journal of Pain
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• 제11권2호
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• pp.311-313
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• 1998

Continuous epidural catheter insertion is common practice in postoperative analgesia. Subarachnoid migration of epidural catheter is a rare complication. Presumed delayed subarachnoid migration of an epidural catheter occured in a 58-year-old female patient after subtotal gastrectomy. Delayed respiratory depression occured 7 hrs after transfer to admission room. She was intubated and had ventilatory care. The fluid from the epidural catheter was examined and the result showed that gucose was 107 mg% and protein was 31 mg%. Immediate naloxone administration and ventilatory care for one day was done. The patient discharged without any sequalae.

• Journal of Korean Neurosurgical Society
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• 제41권5호
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• pp.336-339
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• 2007

Traumatic intracranial aneurysm rarely occurs after a head injury. The authors report a case of a 51-year-old man in whom subarachnoid hemorrhage was developed as a result of delayed traumatic aneurysmal rupture of the distal portion of the middle cerebral artery following a minor, closed-head injury. The unruptured aneurysm had been evident on the magnetic resonance image taken two days prior to onset of the subarachnoid hemorrhage. The clinical presentation and possible underlying mechanism are discussed with a review of pertinent literature.

• Neurospine
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• 제15권4호
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• pp.394-399
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• 2018

Subarachnoid pleural fistula (SPF) is an aberrant communication between the pleural cavity and subarachnoid space, resulting in uncontrolled cerebrospinal fluid drainage. The negative pressure of the pleural cavity creates a continuous suctioning effect, thereby impeding the spontaneous closure of these fistulas. Dural tears or punctures in cardiothoracic procedures, spinal operations, and trauma are known to cause such abnormal communications. Failure to recognize this entity may result in sudden neurological or respiratory complications. Hence, a high index of suspicion is required for early diagnosis and prompt management. Noninvasive positive pressure ventilation has been described to be effective in managing such fistulas, thus mitigating the high morbidity associated with exploratory surgery for primary repair. Herein, we describe the typical presentation of SPF and the clinical course, treatment, and follow-up of a patient who sustained SPF following anterior thoracic spinal surgery.

• Journal of Medicine and Life Science
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• 제19권2호
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• pp.70-73
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• 2022

Here, we report a case of ultrasound-assisted subarachnoid block in a patient with severe kyphosis. A 69-year-old man was scheduled for metal removal from hip screws. He had a previous experience with subarachnoid block using the landmark-guided technique, but it was very difficult due to severe kyphosis. However, we could easily determine the correct needle insertion point using ultrasound imaging and performed a successful dural puncture on the first attempt. This case demonstrates the clinical usefulness of ultrasound imaging for subarachnoid blocks in patients with severe kyphosis.

• 대한한방내과학회지
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• 제41권5호
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• pp.745-753
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• 2020

Background: A number of studies have identified the effect of Korean medicine treatment for oculomotor nerve palsy, but few have reported treatment of subarachnoid hemorrhage. This paper reports two cases of oculomotor nerve palsy with ptosis and limitation of eye movement after subarachnoid hemorrhage whose conditions were improved by Korean medicine treatment. Methods: Two patients with ptosis and limitation of eye movement after subarachnoid hemorrhage were treated with Korean medicine, including acupuncture, electroacupuncture, herbal medicine, cupping, moxibustion, and pharmacoacupuncture. Clinical symptoms were measured as the distance of the interpalpebral fissure and eyeball movement (adduction, abduction). Results: After treatment, their clinical symptoms showed improvement. Conclusion: Korean medicine treatment, including pharmacoacupuncture and electroacupuncture, could be adopted as a treatment method for oculomotor nerve palsy after subarachnoid hemorrhage.