• 제목/요약/키워드: Subarachnoid hemorrhage

검색결과 316건 처리시간 0.041초

Rupturing Anterior Communicating Artery Aneurysm during Computed Tomography Angiography : Three-Dimensional Visualization of Bleeding into the Septum Pellucidum and the Lateral Ventricle

  • Kim, Ealmaan
    • Journal of Korean Neurosurgical Society
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    • 제55권6호
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    • pp.357-361
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    • 2014
  • Computed tomography angiography (CTA) is commonly used in setting of subarachnoid hemorrhage, but imaging features of aneurysm rupturing taking place at the time of scanning has rarely been described. The author reports a case of actively rebleeding aneurysm of the anterior communicating artery with intraventricular extravasation on the hyperacute CTA imaging. The rebleeding route, not into the third ventricle but into the lateral ventricles, can be visualized by real-time three-dimensional CT pictures. The hemorrhage broke the septum pellucidum and the lamina rostralis rather than the lamina terminalis.

Craniopharyngioma with Intratumoral Hemorrhage and Superficial Siderosis

  • Oh, Jeong Hee;Park, Sung-Tae;Lim, Hyun Kyung
    • Investigative Magnetic Resonance Imaging
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    • 제22권4호
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    • pp.249-253
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    • 2018
  • Superficial siderosis of the central nervous system (CNS) is a progressive and debilitating neurological disease manifesting sensorineural hearing loss, cerebellar ataxia, and pyramidal tract signs. Chronic extravasation of blood into the subarachnoid space results in the accumulation of hemoglobin derivate in the subpial layer of the CNS, which is toxic to the neural tissues. Craniopharyngioma is a benign third ventricle tumor, which rarely presents with tumor bleeding. We report a rare case of superficial siderosis associated with craniopharyngioma with intratumoral hemorrhage in a patient with no history of prior trauma or CNS surgery.

Clinical Neuropathological Analysis of 10 Cases of Cerebral Amyloid Angiopathy-Related Cerebral Lobar Hemorrhage

  • Li, Xiao-Qiu;Su, Dong-Feng;Chen, Hui-Sheng;Fang, Qu
    • Journal of Korean Neurosurgical Society
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    • 제58권1호
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    • pp.30-35
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    • 2015
  • Objective : The clinical and pathological characteristics of 10 cases of cerebral amyloid angiopathy (CAA)-related cerebral lobar hemorrhage (CLH) that was diagnosed at autopsy were investigated to facilitate the diagnosis of this condition. Methods : The clinical characteristics of 10 cases of CAA-related CLH were retrospectively reviewed, and a neuropathological examination was performed on autopsy samples. Results : The 10 cases included two with a single lobar hemorrhage and eight with multifocal lobar hemorrhages. In all of the cases, the hemorrhage bled into the subarachnoid space. Pathological examinations of the 10 cases revealed microaneurysms in two, double barrel-like changes in four, multifocal arteriolar clusters in five, obliterative onion skin-like intimal changes in four, fibrinoid necrosis of the vessels in seven, neurofibrillary tangles in eight, and senile plaques in five cases. Conclusion : CAA-related CLHs were located primarily in the parietal, temporal, and occipital lobes. These hemorrhages normally consisted of multiple repeated CLHs that frequently bled into the subarachnoid space. CAA-associated microvascular lesions may be the pathological factor underlying CLH.

외상성 지주막하출혈 이후 발생한 동안신경마비의 봉독 약침을 활용한 한방치료 증례보고 1례 (Case Report of Traumatic Subarachnoid Hemorrhage-Induced Oculomotor Nerve Palsy Treated with Korean Medicine, Including Sweet Bee Venom)

  • 강지윤;양지혜;채인철;최인우;정은선;유호룡;김윤식;설인찬;유주영
    • 대한한방내과학회지
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    • 제42권2호
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    • pp.140-151
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    • 2021
  • The aim of this study is to report the effectiveness of a traditional Korean medicine treatment for oculomotor nerve palsy induced by traumatic subarachnoid hemorrhage. A 54-year-old male patient with oculomotor nerve palsy induced by traumatic subarachnoid hemorrhage after a traffic accident was treated with Korean medicine, including acupuncture, electroacupuncture, sweet bee venom pharmacoacupuction, moxibustion, and herbal medicine. The effect of treatment on symptoms - ptosis, and eye movement - was evaluated using a ratio of eye opening and eye movement between the paralyzed eye and the normal eye. After 41 days of treatment, the clinical symptoms had improved. The ptosis and eye movement started to show improvement from day 20; at the time of discharge, ptosis had improved by more than 50%, and eye movement showed some improvement as well. This study suggests that Korean medicine may be an effective treatment for oculomotor nerve palsy induced by traumatic subarachnoid hemorrhage.

동맥류성 뇌지주막하 출혈후의 수두증에 대한 종판 개구의 효과 (The Effect of Opening Lamina Terminalis on the Development of Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage)

  • 황영학;이동훈;이상훈;김호경;강창구;정의화
    • Journal of Korean Neurosurgical Society
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    • 제29권5호
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    • pp.609-614
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    • 2000
  • Objective : A retrograde clinical study was undertaken to determine the effect of opening lamina terminalis on the development of hydrocephalus after aneurysmal subarachnoid hemorrhage(SAH). We compared the incidence ratios of the development of hydrocephalus with and without opening lamina terminalis during operation after aneurysmal SAH. Patients and Methods : From Oct. 1996 to Sep. 1998, we performed 138 aneurysm surgery for 122 patients. In 98 cases, the lamina terminalis was opened to make direct cerebrospinal fluid flow from the third ventricle to subarachnoid space for prevention of delayed hydrocephalus. We compared the incidence of hydrocephalus after opening lamina terminalis to those without opened lamina terminalis. Results : In 95 cases, the hydrocephalus was noticed in 2 cases(2.2%). It is significantly lower in the group with opening lamina terminalis than the group without opening lamina terminalis(about 10%). Conclusion : It is simple and easy procedure to open the lamina terminalis during aneurysm surgery. With this maneuver, we could reduce the incidence of hydrocephalus after aneurysmal spontaneous SAH. Thus, it is considered that the opening lamina terminalis is one of the effective methods for preventing the development of hydrocephalus after aneurysmal spontaneous SAH.

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뇌 동맥류성 지주막하출혈 환자간호의 질 평가 도구 개발 (Development of a Quality Evaluation Tool for Aneurysmal Subarachnoid Homorrhage Patient Care)

  • 배소현;신성례
    • 성인간호학회지
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    • 제15권4호
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    • pp.628-638
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    • 2003
  • Purpose: The purpose of this study was to develope a evaluation tool of the quality of nursing care for aneurysmal subarachnoid hemorrhage patients at Hunt & Hess Grade I~III. Method: The data was gathered from April 15, 2002 to June 14, 2002. The tool proceeded in six steps according to Bloch's framework. Result: The results of this study are as follows: 1) The quality evaluation tool for neurosurgery ICU consisted of 25 standards and 138 criteria. The quality evaluation tool for ward consisted of 27 standards and 144 criteria.; 2) The content validities of the tools for neurosurgery ICU and ward were 0.96 and 0.98, respectively.; 3) The Pearson coefficients for evaluating the interrated reliability of the tools for neurosurgery ICU and ward were r=0.9106 (p<0.1) and r=0.8807 (p<0.1), respectively.; 4) The ranges of corrected item-total correlations for evaluating the construct validity of the tools for neurosurgery ICU and ward were 0.0279~0.9354 and 0.0174~0.9682, respectively.; And 5) The ranges of Cronbach's ${\alpha}$ reliabilities for evaluating the internal consistency reliability of the tools for neurosurgery ICU and ward were 0.6040~0.8554 and 0.6212~0.9584, respectively. Conclusion: The tools developed in this study seem useful in evaluating the quality of nursing care for aneurismal subarachnoid hemorrhage patients at Hunt & Hess Grade I-III.

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Spinal Subarachnoid Hematoma as a Complication of an Intramuscular Stimulation : Case Report and a Review of Literatures

  • Lee, Myeong Jong;Chung, Young Sun
    • Journal of Korean Neurosurgical Society
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    • 제54권1호
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    • pp.58-60
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    • 2013
  • Intramuscular stimulation (IMS) is widely used to treat myofascial pain syndrome. IMS is a safe procedure but several complications have been described. To our knowledge, spinal subarachnoid hematoma has never been reported as a complication of an IMS. The authors have experienced a case of spinal subarachnoid hematoma occurring after an IMS, which was tentatively diagnosed as intracranial subarachnoid hemorrhage because of severe headache. Patient was successfully treated with surgery. Here, we report our case with a review of literature.

중대뇌동맥 동맥류 파열 환자의 출혈 양상에 대한 임상적 분석 (The Clinical Analysis of Bleeding Pattern in Patients with Ruptured Middle Cerebral Artery Aneurysm)

  • 김훈;심영보;황형식;최재준;김성민;박용기;최선길
    • Journal of Korean Neurosurgical Society
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    • 제30권6호
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    • pp.699-704
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    • 2001
  • Objectives : The rupture of middle cerebral artery(MCA) aneurysm usually cause or is associated with higher incidence of intracerebral hemorrhages(ICH) than any other aneurysmal ruptures. Also, the outcome of patients who had ICH is known to be worse than patients who had subarachnoid hemorrhage(SAH) only. The authors report the bleeding pattern and outcome of ruptured MCA aneurysm patients. Patients and Methods : A total 106 ruptured MCA aneurysm patients who were surgically treated were included and they were divided into 2 groups by the initial brain CT findings according to the presence or absence of ICH over 10cc in amount. The clinical data were analysed retrospectively. Results : The overall mortality was 18.9%. Among 81 patients(76.4%) who had subarachnoid hemorrhage(SAH) only, 68 patients(84%) showed favorable outcome. Twenty five patients(23.6%) had ICH over 10cc in amount with or without SAH, and among them, 11 patients(44%) showed favorable outcome. The ICH was located in temporal lobe(15 patients, 60%), frontal lobe(3, 12%), sylvian fissure(6, 24%) and frontal-temporal lobe(1, 4%). Among 15 patients who had ICH in temporal lobe, only 4 patients(26.6%) showed favorable outcome and all 3 patients who had ICH in frontal lobe showed favorable outcome. Conclusion : ICH was presented in 23.6% of ruptured MCA aneurysm patients and the prognosis of patients with ICH was worse than patients with SAH only. The ICH was located mainly in the temporal lobe and sylvian fissure.

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Effect of Cisternal Drainage on the Shunt Dependency Following Aneurysmal Subarachnoid Hemorrhage

  • Kim, Sung Hun;Chung, Pil-Wook;Won, Yu Sam;Kwon, Young Joon;Shin, Hyun Chul;Choi, Chun Sik
    • Journal of Korean Neurosurgical Society
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    • 제52권5호
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    • pp.441-446
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    • 2012
  • Objective : Shunt-dependent chronic hydrocephalus (SDCH) is known to be a major complication associated with aneurysmal subarachnoid hemorrhage (aSAH). Old age is known to be one of numerous factors related to the development of SDCH. This study investigated whether postoperative cisternal drainage affects the incidence of SDCH and clinical outcome in elderly patients with aSAH. Methods : Fifty-nine patients participated in this study. All patients underwent aneurysmal clipping with cisternal cerebrospinal fluid (CSF) drainage. Clinical variables relevant to the study included age, sex, location of ruptured aneurysm, CT finding and clinical state on admission, clinical outcome, and CSF drainage. We first divided patients into two groups according to age (<70 years of age and ${\geq}70$ years of age) and compared the two groups. Secondly, we analyzed variables to find factors associated with SDCH in both groups (<70 years of age and ${\geq}70$ years of age). Results : Of 59 patients, SDCH was observed in 20 patients (33.9 %), who underwent shunt placement for treatment of hydrocephalus. Forty seven percent of cases of acute hydrocephalus developed SDCH. In the elderly group (${\geq}70$ years of age), the duration and amount of CSF drainage did not affect the development of chronic hydrocephalus. Conclusion : In elderly patients, although the incidence of SDCH was significantly higher, clinical outcome was acceptable. The duration and the amount of cisternal drainage did not seem to be related to subsequent development of chronic hydrocephalus within elderly patients aged 70 or older.