• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.1050-1061
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• 2023

This study reported the case of a patient with quadriparesis due to cerebral aneurysm rupture, subarachnoid hemorrhage, and intraventricular hemorrhage (IVH) treated with Korean medicine. The patient was treated with acupuncture, herbal medicine (mainly Tonggyuhwalhyeol-tang-gagam), Western medicine, moxibustion, cupping, and rehabilitative therapy for 75 days, and improved after administration. After treatment, the Manual Muscle Test grade improved from 4/4-/3+/3 to 4+/4+/4+/4+, the Korean version of the modified Barthel Index score improved from 9 to 100, the National Institute of Health's Stroke Scale score improved from 2 to 0, the Global Deterioration Scale score improved from 3 to 2, and the Korean version of the Mini-Mental State Examination score improved from 22 to 30. During administration, the patient did not show seizures, shock, or loss of consciousness, and the vital signs were stable in the normal range. We followed up the brain computed tomography findings for 2 times and found that there was no definite evidence of intracranial hemorrhage or IVH or re-rupture or rebleeding after Korean medicine treatment. This study suggests that Korean medicine treatment with blood-invigorating and stasis-removing herbs could be a safe and effective intervention option for improving quadriparesis due to cerebral aneurysm rupture and subarachnoid hemorrhage.

• 대한약리학회:학술대회논문집
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• 2006.10a
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• pp.112.1-112.1
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• 2006

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.764-771
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• 2018

The purpose of this study was to investigate the cases diagnosed as subarachnoid hemorrhage by noncontrast computed tomography (NCCT) after the appearance of symptoms related to headache and paralysis in patients who visited a Korean medicine hospital. A search of electronic medical records of patients diagnosed with subarachnoid hemorrhage on NCCT in W Korean medicine hospital from January 2010 to December 2017 identified five patients. The patients (four women and one man) ranged in age from 64 to 79 years old. Three were inpatients and two were outpatients. Two patients had hypertension, two patients had diabetes, two patients had heart disease, and two patients had a history of cerebral infarction. Development of a cooperative system is needed for accurate diagnosis and appropriate treatment of this disease in the Korean medicine clinic and for establishment of an NCCT scan application method.

• Journal of Korean Neurosurgical Society
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• v.56 no.5
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• pp.428-430
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• 2014

Isolated traumatic pseudoaneurysms of the basilar artery are extremely rare but often fatal resulting in a mortality rate as high as 50%. A 51-year-old man presented with craniofacial injury after blunt trauma. A brain computed tomography (CT) scan showed thick basal subarachnoid hemorrhage associated with multiple craniofacial fractures, while CT angiography revealed contrast extravasation at the distal basilar artery with pseudoaneurysm formation. After this primary survey, the condition of the patient suddenly deteriorated. Conventional angiography confirmed the contrast extravasation resulted from pseudoaneurysm formation, which was successfully treated with endovascular coil embolization. Decompressive craniectomy and coma therapy with propofol were also performed. However, the patient died on the 7th hospital day because of the poor initial clinical condition. The current case is the first report of acute pseudoaneurysm rupture arising from the basilar artery within the first day after trauma. Our findings suggest the possibility that pseudoaneurysm rupture should be considered if brain CT shows thick traumatic subarachnoid hemorrhage on the basal cistern with a basal skull fracture.

• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.502-507
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• 2020

This study aimed to investigate the effect of Hwanglyeonhaedok-tang on the clearance of vancomycin-resistant Enterococcus (VRE) colonization in a patient with traumatic subarachnoid hemorrhage and subdural hematoma. A 73-year-old man who was diagnosed with traumatic subarachnoid hemorrhage and subdural hematoma with isolation of VRE colonization was administered Hwanglyeonhaedok-tang and followed up with a rectal swab VRE culture every week. After treatment with Hwanglyeonhaedok-tang, VRE colonization was no longer detected. This case report proved that Hwanglyeonhaedok-tang could be an effective treatment for clearance of VRE colonization in a patient with traumatic subarachnoid hemorrhage and subdural hematoma.

• Journal of Korean Neurosurgical Society
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• v.42 no.3
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• pp.173-178
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• 2007

Objective : Hydrocephalus is one of the major complications following spontaneous subarachnoid hemorrhage (SAH). However, the risk factors of the hydrocephalus after SAH are not still well known. This study was focused on verification of the causal relationships between the development of hydrocephalus and SAH. Methods : The patients who developed hydrocephalus after rupture of aneurysms were studied. To obtain prognostic factors regarding to hydrocephalus, several parameters such as age, sex, hypertension, location of aneurysm, existence of intraventricular hemorrhage (IVH) and intracerebral hemorrhage (ICH), Glasgow coma scale (GCS), Hunt-Hess SAH classification & Fisher Grade on admission and the ratio of frontal harn of lateral ventricle diameter to skull inner table diameter at this level (FH/ID) were studied retrospectively. Results : The development of hydrocephalus following SAH is multifactorial. The age, IVH, FH/ID ratio were related to hydrocephalus in analysis. There is a low clinical correlation between sex, hypertension, location of aneurysm, existence of ICH, GCS, Hunt-Hess SAH classification, Fisher Grade on admission and hydrocephalus. Conclusion : Knowledge on risk factors related to the occurrence of hydrocephalus may help guide neurosurgeons in the long-term care of patients who have experienced aneurysmal SAH.

• Journal of Korean Neurosurgical Society
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• v.43 no.4
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• pp.177-181
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• 2008

Objective : Hydrocephalus is a common sequelae of aneurysmal subarachnoid hemorrhage (SAH) and patients who develop hydrocephalus after SAH typically have a worse prognosis than those who do not. This study was designed to identify factors predictive of shunt-dependent chronic hydrocephalus among patients with aneurysmal SAH, and patients who require permanent cerebrospinal fluid diversion. Methods : Seven-hundred-and-thirty-four patients with aneurysmal SAH who were treated surgically between 1990 and 2006 were retrospectively studied. Three stages of hydrocephalus have been categorized in this paper, i.e., acute (0-3 days after SAH), subacute (4-13 days after SAH), chronic (${\geqq}14$ days after SAH). Criteria indicating the occurrence of hydrocephalus were the presence of significantly enlarged temporal horns or ratio of frontal horn to maximal biparietal diameter more than 30% in computerized tomography. Results : Overall, 66 of the 734 patients (8.9%) underwent shunting procedures for the treatment of chronic hydrocephalus. Statistically significant associations among the following factors and shunt-dependent chronic hydrocephalus were observed. (1) Increased age (p < 0.05), (2) poor Hunt and Hess grade at admission (p < 0.05), (3) intraventricular hemorrhage (p < 0.05), (4) Fisher grade III, IV at admission (p < 0.05), (5) radiological hydrocephalus at admission (p < 0.05), and (6) post surgery meningitis (p < 0.05) did affect development of chronic hydrocephalus. However the presence of intracerebral hemorrhage, multiple aneurysms, vasospasm, and gender did not influence the development of shunt-dependent chronic hydrocephalus. In addition, the location of the ruptured aneurysms in posterior cerebral circulation did not show significant correlation of development of shunt-dependent chronic hydrocephalus. Conclusion : Hydrocephalus after aneurysmal subarachnoid hemorrhage seems to have a multifactorial etiology. Understanding predisposing factors related to the shunt-dependent chronic hydrocephalus may help to guide neurosurgeons for better treatment outcomes.

• Journal of Korean Neurosurgical Society
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• v.46 no.1
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• pp.60-64
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• 2009

Nontraumatic intracranial subarachnoid hemorrhage (SAH) attributable to the thoracolumbar dural arteriovenous fistulas (DAVFs) has been extremely rare. A 41-year-old male patient was admitted with severe acute headache, neck stiffness, and pronounced low-back pain radiating to both legs. The T2-weighted MR imaging showed irregular signal void and enlarged, varix like pouch formation with spinal cord compression at the T11-12 level. The angiogram revealed a DAVF. We report a DAVF case with SAH that revealed an extensive infarction from C5 to the conus medullaris after undergoing operative treatment.

• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.123-126
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• 2007

A 58-year-old woman was admitted to our department due to headache. Brain computed tomography [CT] indicated subarachnoid hemorrhage [SAH], and emergency angiography showed dissecting aneurysm involving the left A1 segment We performed trapping of dissecting A1 aneurysm and the postoperative course was uneventful. We present a case of dissecting aneurysm in the anterior cerebral artery with spontaneous SAH which was treated by early surgery and resulted in clinically good prognosis.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.492-494
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• 2009

The authors report a case of recurrent subarachnoid hemorrhage (SAH) after complete occlusion of an intracranial aneurysm. It is known that regrowth of an aneurysm after the complete clipping is a rare event. For detection of recurrence, however, it may be necessary to follow up with the patient regularly after the initial operation for intracranial aneurysms, because re-rupture of an aneurysm can cause a fatal result, and the cumulative risk of a recurrent SAH is thought to be not low over time.