• Journal of Korean Neurosurgical Society
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• 제45권3호
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• pp.199-202
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• 2009

We report the case of a 64-year-old man with dural arteriovenous fistula (DAVF) at right jugular foramen, presented as subarachnoid and intraventricular hemorrhage. The malformation was fed by only the neuromeningeal trunk of the right ascending pharyngeal artery and drained into the right lateral medullary veins craniopetally. Complete embolization was attained by selective transarterial glue injection, but patient showed lower cranial neuropathies. A 3-month follow-up angiogram still showed persistent fistula occlusion. Transarterial glue embolization is a feasible method, only if a transvenous access is not possible in case of single channel fistula.

• 사상체질의학회지
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• 제21권3호
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• pp.186-192
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• 2009

1. Objective: This study is about a Soyangin patient with vertigo after subarachnoid hemorrhage. In this study, we report the effects of Sasang constitutional treatment to this patient. 2. Methods: This patient was treated by Soyangin's constitutional medications and acupunture according to the result of Sasang constitutional diagnosis. 3. Results and Conclusions: This patient's chief complaints were vertigo and gait disturbance. By using Yangkyuksanhwa-tang mainly, she showed positive response about her symptom. This study shows that Yangkyuksanhwa-tang has effect to vertigo in Soyangin.

• Journal of Korean Neurosurgical Society
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• 제54권1호
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• pp.50-53
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• 2013

Spinal subarachnoid hemorrhage (SAH) due to solitary spinal aneurysm is extremely rare. A 45-year-old female patient visited the emergency department with severe headache and back pain. Imaging studies showed cerebral SAH in parietal lobe and spinal SAH in thoracolumbar level. Spinal angiography revealed a small pearl and string-like aneurysm of the Adamkiewicz artery at the T12 level. One month after onset, her back pain aggravated, and follow-up imaging study showed arachnoiditis. Two months after onset, her symptoms improved, and follow-up imaging study showed resolution of SAH. The present case of spinal SAH due to rupture of dissecting aneurysm of the Adamkiewicz artery underwent subsequent spontaneous resolution, indicating that the wait-and-see strategy may provide adequate treatment option.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.137-139
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• 2010

A subarachnoid hemorrhage (SAH) associated with negative finding on four-vessel angiography is seen in 5 to 30% of patients with intracranial SAH. A previously silent lesion in the spinal canal may be responsible for the angiographically negative finding for cause of intracranial SAH. We report a case of upper cervical (C1-2) intradural schwannoma presenting with acute intracranial SAH. Repeated cerebral angiographic studies were negative, but cervical magnetic resonance imaging study and tissue pathology revealed a intradural-extramedullary schwannoma in C1-2 level. This case illustrates the importance of a high index of clinical suspicion for spinal disease in angiographically negative intracranial SAH patients.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.172-177
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• 2022

Takotsubo or reverse Takotsubo cardiomyopathy is a well-known cardiac complication of subarachnoid hemorrhage (SAH) that shows transient left ventricular wall motion abnormalities with electrocardiogram (ECG) changes. ST change followed by T inversion is a common ECG finding complicated with these disorders, left bundle branch block (LBBB) may be a potential ECG pattern which is seen. In this case, we describe the clinical profile and outcomes of a patient with LBBB and reverse Takotsubo cardiomyopathy after anesthetic induction, which was scheduled as an emergent external ventricular drainage after SAH. This is the first report of an LBBB pattern in reverse Takotsubo cardiomyopathy.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권1호
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• pp.69-74
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• 2023

Subarachnoid hemorrhage (SAH) due to ruptured posterior cerebral artery (PCA) intracranial arterial dolichoectasia (IADE) is very rare. As these lesions are difficult to treat microsurgically, neurointervention is preferred because the dolichoectatic artery does not have a clear neck, and the surgical field of view was deep seated with the SAH. However, in some cases, neurointervention is difficult due to anatomical variation of the blood vessel to access the lesion. In this case, a 30-year-old male patient presented with a ruptured PCA IADE and an aortic arch anomaly. Aortic arch anomalies render it difficult to reach the ruptured PCA IADE via endovascular treatment. The orifice of the vertebral artery (VA) was different from the usual cases, so it was difficult to find the entrance. After only finding the VA and arriving at the lesion along the VA, trapping was performed. Herein, we report the PCA IADE with aortic arch anomaly endovascular treatment methods and results.

• 한국한의학연구원논문집
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• 제1권1호
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• pp.1-14
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• 1995

The clinical study was carried out on 1737 cases of inpatient and outpatient which have been diagnosed as C.V.A at hospital attached to 8 colleges of oriental medicine in Korea or National Medical Center from January 1st 1994 to December 31st 1994. The results were as follows; 1. In this study, the case of Occlusive C.V.D was 70.1%, Cerebral hemorrhage was 20.5%, Transient ischemic attack (T.I.A) was 5.3%, Subdural hemorrhage was 3.0%, Subarachnoid hemorrhage was 0.8% 2. It was confirmed by C.T (20%), E.K.G. (19%), X-ray (19%), Urinalysis (19%), Hematoscopy (20%). 3. The mean days of hospital treatment was 27.88 days, mean days of ambulation was 70.34 days. The mean days of hospital treatment of Occlusive C.V.D, Cerebral hemorrhage, T.I.A., Subdural hemorrhage, Subarachnoid hemorrhage were 25.79, 39.32, 12.49, 16.23, 23.40 days, respectively. The mean days of ambulation of Occlusive C.V.D, Cerbral hemorrhage, T.I.A., Subdural hemorrhage, Subarachnoid hemorrhage were 74.40, 93.68, 69.10, 29.75, 32.57 days, respectavely. 4. Oriental medical treatment of C.V.A was mainly Acupuncture (25%), Paper of Chinese herbs (22%), Chinese physiotherapy (14%), Extract of Chinese herbs (11%). 5. Oriental medical physiotherapy for C.V.A was mostly E.S.T., Kinesiatrics, electric negative therapy, others Aerohydrotherapy, interferential current therapy (I.C.T.), Carbon, Samhogi, T.E.N.S., Ultra-sound, Infra-red, Microwave, T.D.P., Ultraviolet, S.S.P., Chinese herbs beth, Prarffin bath, Magnetic treatment and tractions.

• Journal of Korean Neurosurgical Society
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• 제53권1호
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• pp.59-61
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• 2013

Authors report a rare case of acute intracranial subdural and intraventricular hemorrhage that were caused by intracranial hypotension resulted from cerebrospinal fluid leakage through an unidentified dural tear site during spinal surgery. The initial brain computed tomography image showed acute hemorrhages combined with preexisting asymptomatic chronic subdural hemorrhage. One burr hole was made over the right parietal skull to drain intracranial hemorrhages and subsequent drainage of cerebrospinal fluid induced by closure of the durotomy site. Among various methods to treat cerebrospinal fluid leakage through unidentified dural injury site, primary repair and spinal subarachnoid drainage are well known treatment options. The brain imaging study to diagnose intracranial hemorrhage should be taken before selecting the treatment method, especially for spinal subarachnoid drainage. Similar mechanism to its spinal counterpart, cranial cerebrospinal fluid drainage has not been mentioned in previous article and could be another treatment option to seal off an unidentified dural tear in particular case of drainage of intracranial hemorrhage is needed.

• Journal of Korean Neurosurgical Society
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• 제57권3호
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• pp.167-173
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• 2015

Objective : Removal of blood from subarachnoid space with a lumbar drainage (LD) may decrease development of cerebral vasospasm. We evaluated the effectiveness of a LD for a clinical vasospasm and outcomes after clipping of aneurysmal subarachnoid hemorrhage (SAH). Methods : Between July 2008 and July 2013, 234 patients were included in this study. The LD group consisted of 126 patients, 108 patients in the non LD group. We investigated outcomes as follow : 1) clinical vasospasm, 2) angioplasty, 3) cerebral infarction, 4) Glasgow outcome scale (GOS) score at discharge, 5) GOS score at 6-month follow-up, and 6) mortality. Results : Clinical vasospasm occurred in 19% of the LD group and 42% of the non LD group (p<0.001). Angioplasty was performed in 17% of the LD group and 38% of the non LD group (p=0.001). Cerebral infarctions were detected in 29% and 54% of each group respectively (p<0.001). The proportion of GOS score 5 at 6 month follow-up in the LD group was 69%, and it was 58% in the non LD group (p=0.001). Mortality rate showed 5% and 10% in each group respectively. But, there was no difference in shunt between the two groups. Conclusion : LD after aneurysmal SAH shows marked reduction of clinical vasospasm and need for angioplasty. With this technique we have shown favorable GOS score at 6 month follow-up.

• 대한한방내과학회지
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• 제19권1호
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• pp.168-184
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• 1998

Clinical Observation was made on 120 Cases of CVA that were confirmed through brain CT of Oriental Medical hospital of Se-Myung University from July in 1997 to June in 1998. 1. The CVA cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), and the greatest in number among them were the cases of cerebral infarction. 2. The most cases were 50 of age in all cases, in cerebral infarction were over 70 of age. There is no significant difference in the frequency of strokes between the male and female. the ratio was 1.07 : 1. 3. The frequency of strokes seems to have no relation to month and season. 4. The course of entering hospital, most patients visited this hospital directly(not through any other hospital) within 24hours. 5. The first attack was noted in 80.8%, the recurrance attack in 19.2% and the cerebral infarction had high recurrance ratio compared with cerebral hemorrhage. 6. The average duration of hospitalization was 25.2 days. 7. The most ordinary preceding disease was hypertension. 8. The common symptoms were motor disturbance and dysphasia. 9. The most frequent location of the lesion in cerebral infarction was parietal lobe, in cerebral hemorrhage was basal ganglia. 10. According to electrocardiography findings, abnormality was noted in cerebral infarction more than cerebral hemorrhage, subarachnoid hemorrhage. 11. The hypercholesterolemia and hypertriglyceridemia were found more frequently in cerebral infarction than cerebral hemorrhage, subarachnoid hemorrhage. 12. The average time to start physical theraphy was 7.76 days after admission. 13. The most common complications were pneumonia and bed sore.