• Title/Summary/Keyword: Subarachnoid hemorrhage

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The clinical study of the effect of Jamyang.Jaum prescriptions on the hypertension evolution in cerebral hemorrhage patients (잠양자음약물(潛陽滋陰藥物)이 뇌출혈(腦出血) 환자(患者)의 고혈압(高血壓)에 미치는 영향(影響)에 대한 임상적(臨床的) 고찰(考察))

  • Choi, Cheol-Won;Kim, Dong-Woung;Shin, Sun-Ho;Jeon, Heui-Jun;Hwang, Bo-Youn;Jeong, Dae-Young
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.72-81
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    • 1997
  • The causes of stroke are presumed hypertension, atherosclerosis,. cardiac disease, diabetes mellitus and old age and risk factors of stroke are suggested hypertension, hyperlipidemia. obesity, smoking and drinking etc. Especilly, hypertension is one of the most important cause and risk factor of stroke, therfore without therapy hypertension leads to stroke. The frequence of hypertension is significantly higher in hemorrhage patients of intracranial hemorrhage and subarachnoid hemorrhage. Antihypertensive therapy has an impact not only on the primary prevention of stroke but also on stroke recurrence and the declining of stroke motality has been attributed to the widespread availability and use of antihypertensive therapy. The goals of antihypertensive therapy decrease the complications and motalitv of cardiovascular system and prevent the promoting arteriosclerosis. In this study, we observed the blood pressure change of cb-hemorrhagic patients with hypertension who were hospitalized from 1996. 3. 1 to 1997. 2 .26 in Wonkwang Oriental Hospital. These patients had no antihypertensive therapy and were supplied herb med(Jaum sikpoongtang, Chungrijagamtang, Gojinumja) in medication. Our results suggested as follows. 1. Systolic and diastolic average BP at admission is $150.71{\pm}15.61mmHg$ and $95.00{\pm}8.8mmHg$ and this is hypertension state defining WHO 2. During one week in admission, the blood pressure demostrated a marked declination by SBP 8.97mmHg and DBP 6.22mmHg. 3. During two week in admission, the declination of SBP was significant in paired t-test(p<0.05) but, the declination of DBP was non-significant in paired t-test. 4. The blood pressure during third and fourth weeks gradually declined but, non-significant in test. According to the above results, we suggested that the BP declination Was affected by $Jamyang{\cdot}Jaum$ prescriptions in acute stage of cerebral hemorrhage.

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Spinal Intradural Extramedullary Cavernoma Presenting with Intracranial Superficial Hemosiderosis

  • Jin, Yong-Jun;Chung, Sang-Bong;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.377-380
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    • 2011
  • A case of intradural extramedullary cavernous angioma is presented with headache, dizziness, and bilateral sensorineural hearing loss caused by an intracranial superficial hemosiderosis. It was incidentally found in a patient with a 3-month history of sustained headache, dizziness and a 3-year history of hearing difficulty. The neurological examination was unremarkable in the lower extremity. MR images showed an intracranial superficial hemosiderosis mostly in the cerebellar region. Myelography and MR images of the thoracolumbar spine revealed an intradural extramedullary mass, which was pathologically proven to be a cavernous angioma. T12 total laminoplastic laminotomy and total tumor removal were performed without any neurologic deficits. The patient's symptoms, including headache and dizziness, have been absent for three years. Intradural extramedullary cavernous angioma can present with an intracranial superficial hemosiderosis as a result of chronic subarachnoid hemorrhage.

Multiple Dissecting Aneurysms of the PICA Trunk - Case Report - (다발성 후하소뇌동맥 해리성 동맥류 - 증 례 보 고 -)

  • Kim, Jong Tae;Kim, Han Kyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.66-72
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    • 2001
  • Apatient with multiple dissecting aneurysms of a posterior inferior cerebellar artery trunk who presented with SAH is reported. A 58-year-old woman presented with sudden occipital headache, dizziness and vomiting. The intial vertebral angiography revealed a suspicious pearl and string sign at the proximal posterior inferior cerebellar artery(PICA) segment. After 2 weeks, follow up angiography showed a progression of the proximal PICA dissection and newly developed dissecting aneurysm of the distal PICA segment. A far lateral suboccipital transcondylar appoach confirmed two dissecting aneurysms at distant sites of the PICA trunk. The dissection segments were wrapped with muslin wrap, which preserved the flow through the PICA and brain stem perforators. The angiographys at 3 weeks and 6 months after operation revealed serial disappearance of the dissecting aneurysms which is distal to proximal. The diagnosis, course and treatment of the dissecting aneurysms of the PICA are discussed with literature review.

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Coil Embolization for Distal Middle Cerebral Artery Aneurysm

  • Cho, Chun-Sung;Kim, Young-Joon;Lee, Sang-Koo;Cho, Maeng-Ki
    • Journal of Korean Neurosurgical Society
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    • v.41 no.3
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    • pp.193-195
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    • 2007
  • Middle cerebral artery [MCA] aneurysms are a common source of subarachnoid hemorrhage [SAH]. But, ruptured distal MCA aneurysm is very rare, and their clinical and radiological features are poorly understood. Microsurgical repair remains the most common method used to treat distal MCA aneurysm, even though endovascular coiling has been favored recently. We report our experience of successful coiling for ruptured distal MCA aneurysm, In selected patients, coiling may be a good treatment option for ruptured distal MCA aneurysm.

Modified 'Y-Configured Stents with Waffle Cone Technique' for Broad Neck Basilar Top Aneurysm

  • Cho, Jun-Sung;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.517-519
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    • 2011
  • Stent assisted coiling on intracranial broad neck aneurysm has been considered as an effective technique and has made the complex aneurysms amenable to coiling. However, stent navigation and application themselves often have the problems especially when the parent vessel angle (entrance between afferent and efferent vessel) is over 90 degrees. We report here a case of a ruptured broad neck basilar top aneurysm that was successfully coiled using two self-expandable stents (Enterprise and Neuroform) placed in a fashion of modified Y-configured stents with waffle cone technique.

Angiographically Progressive Change of Traumatic Pseudoaneurysm Arising from the Middle Meningeal Artery

  • Lee, Jae-Yoon;Lee, Cheol-Young;Kim, Hyun-Woo
    • Journal of Korean Neurosurgical Society
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    • v.56 no.5
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    • pp.423-427
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    • 2014
  • Traumatic pseudoaneurysms of the middle meningeal artery (MMA) are rare phenomenon, which are usually associated with head trauma such as an underlying skull fracture. They were usually known to cause acute or delayed epidural hematomas but can be associated with subdural, subarachnoid, or even intracerebral hemorrhage. Sometimes, a high mortality rate was reported in these circumferences. But the natural course of these pseudoaneurysms is not well recognized. The indication and guideline of treatment for pseudoaneurysm are also unclear. This report describes a rare case of angiographically progressive change of traumatic pseudoaneurysm of the middle meningeal artery for one week, which was treated with endovascular embolization.

Use of the Sundt Clip Graft in a Previously Coiled Internal Carotid Artery Blister-Like Aneurysm

  • Cho, Jae Ik;Cho, Jae Hoon
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.496-499
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    • 2014
  • Owing to the focal wall defect covered with thin fibrous tissues, an aneurysm arising from the dorsal wall of the internal carotid artery (ICA) is difficult to manage either surgically or endovascularly and is often associated with high morbidity and mortality. Unfortunately, the definitive treatment modality of such highly risky aneurysm has not yet been demonstrated. Upon encountering the complex intracranial pathophysiology of such a highly precarious aneurysm, a neurosurgeon would be faced with a challenge to decide on an optimal approach. This is a case of multiple paraclinoid aneurysms including the ICA dorsal wall aneurysm, presented with spontaneous subarachnoid hemorrhage. With respect to treatment, direct clipping with a Sundt graft clip was performed after multiple endovascular interventions had failed. This surgical approach can be a treatment modality for a blood blister-like aneurysm after failed endovascular intervention(s).

Rupture of De Novo Anterior Communicating Artery Aneurysm 8 Days after the Clipping of Ruptured Middle Cerebral Artery Aneurysm

  • Ha, Sung-Kon;Lim, Dong-Jun;Kim, Sang-Dae;Kim, Se-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.236-238
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    • 2013
  • Rapidly developed de novo aneurysm is very rare. We present a rapidly developed and ruptured de novo anterior communicating aneurysm 8 days after the rupture of another aneurysm. This de novo aneurysm was not apparent in the initial 3-dimensional computed tomography and digital subtraction angiography. We reviewed the literature and discussed possible mechanisms for the development of this de novo aneurysm.

Internal Carotid Artery Aneurysms Arising from the Medial Wall of the Communicating Segment of the Internal Carotid Artery - Case Report - (교통동맥분절의 내측벽에서 기원한 내경동맥류 치험 2례 - 증례보고 -)

  • Lee, Jong-Won;Suk, Jong-Sik;Kwon, Jung-Taek;Min, Byung-Kook
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1352-1356
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    • 2000
  • Aneurysms of the medial wall of the internal carotid artery(ICA) constitute a rare group of ICA aneurysms arising at locations other than at arterial division. Because these aneurysms usually have thin walls and wide necks associated with arteriosclerosis, neck clipping should be taken into special consideration. The authors report two cases of the aneurysm presented with subarachnoid hemorrhage, in which neck clippings ware performed with impunity.

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In Situ Intersegmental Anastomosis within a Single Artery for Treatment of an Aneurysm at the Posterior Inferior Cerebellar Artery : Closing Omega Bypass

  • Lee, Sung Ho;Choi, Seok Keun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.467-470
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    • 2015
  • A 74-year-old patient was diagnosed with a subarachnoid hemorrhage suspected from a dissecting aneurysm located at the lateral medullary segment of the posterior inferior cerebellar artery (PICA). Because perforators to the medulla arose both proximal and distal to the dissecting segment, revascularization for distal flow was essential. However, several previously reported methods for anastomosis, such as an occipital artery-PICA bypass or resection with PICA end-to-end anastomosis could not be used. Ultimately, we performed an in situ side-to-side anastomosis of the proximal loop of the PICA with distal caudal loops within a single artery, as a "closing omega," followed by trapping of the dissected segment. The aneurysm was obliterated successfully, with intact patency of the revascularized PICA.