• The Journal of Internal Korean Medicine
• /
• v.39 no.2
• /
• pp.165-175
• /
• 2018

Purpose: To report on a patient with subarachnoid hemorrhage and deep vein thrombosis treated with a combination of Korean and Western medicine. Methods: A patient diagnosed with subarachnoid hemorrhage and deep vein thrombosis was treated with herbal medicine (加減淸熱瀉濕湯 (Gagam-cheongyeolsaseub-tang)), acupuncture (GV2, GB20, LI11, LI4, TE5, GB34, ST36, SP9, ST38, GB39, SP6, LR3), moxibustion (CV6, CV9), and Western medicine for deep vein thrombosis and subarachnoid hemorrhage. To evaluate edema, one of the classic symptoms of deep vein thrombosis, we measured leg circumference at a specified time. Results: After taking Gagam-cheongyeolsaseub-tang and being treated with acupuncture, moxibustion, and Western medicine, the patient showed improvement in leg edema. The left calf circumference decreased from 37.5 cm to 34.5 cm. Conclusions: Korean medicine, acupuncture, moxibustion, and Western medicine may provide effective treatment for deep vein thrombosis in patients with subarachnoid hemorrhage, but further study is needed.

• Journal of The Korean Society of Emergency Medicine
• /
• v.29 no.5
• /
• pp.449-454
• /
• 2018

Objective: The SAFARI score was introduced to assess the risk of convulsive seizure during admission for aneurysmal subarachnoid hemorrhage in 2017. This study was conducted to determine whether the SAFARI score derived from the afore-mentioned study could be applied to patients with aneurysmal subarachnoid hemorrhage in Korea. Methods: We conducted a retrospective study of patients who were diagnosed with aneurysmal subarachnoid hemorrhage from March 2013 to October 2017. Patients' age, sex, blood pressure, pulse rate, body temperature, Glasgow-Coma Scale, Hunt-Hess scale, modified Fisher grade, size of ruptured aneurysm, surgery type, transfusion, and SAFARI score were compared between the seizure and non-seizure groups. The area under the receiver operator characteristic curves was calculated to evaluate the predictive ability for seizure during admission. Logistic regression analysis was used to analyze predictive factors for seizure during admission. Results: A total of 220 patients were included. Ninety-seven (44.1%) were male and 123 (55.9%) were female. The mean age of the patients was 65.8 years old (range, 56-75). The area under the curve of the SAFARI score for predicting seizure was 0.813. The SAFARI score was the only significant predictor of seizure during admission, while other factors were not statistically significant upon logistic regression analysis. Conclusion: The SAFARI score could be used for predicting seizure during admission in patients with aneurysmal subarachnoid hemorrhage.

• Journal of Korean Neurosurgical Society
• /
• v.66 no.2
• /
• pp.205-210
• /
• 2023

Delayed cerebral ischemia (DCI) remains a devastating complication in subarachnoid hemorrhage (SAH), however, there were no present reports that is associated with a ruptured spinal arteriovenous fistula (sAVF). We would like to present a rare case of DCI following embolization of a ruptured perimedullary sAVF. Initially, the patient clinical symptoms mimic a SAH caused by a ruptured intracranial aneurysm. Further evaluation revealed that the SAH was caused by a ruptured perimedullary sAVF and the patient's condition improved following the embolization procedure. Three days later, the patient developed an acute left-sided facial and motor weakness, which persisted until the patient was discharged on the day-15 onset. A magnetic resonance imaging and angiography is performed 1.5 years after discharge and revealed no signs of cerebral infarction and hemorrhage. In this paper, we reported DCI after embolization in a ruptured sAVF with SAH, supported by evidence from the current literature. We would like to also stress the importance of complete spinal and cerebral vessel imaging to reveal the underlying abnormalities and determine the most appropriate intervention.

• Journal of Korean Neurosurgical Society
• /
• v.38 no.4
• /
• pp.303-305
• /
• 2005

The incidence of intracranial aneurysms in childhood is rare, especially in infancy. We report a case of a 45-day-old girl who presented with seizure due to a ruptured large saccular aneurysm of the middle cerebral artery[MCA] with subsequent subarachnoid, intracerebral and intraventricular hemorrhage. The baby has enjoyed an excellent clinical outcome after surgical management. The clinical features of the case and review of the literature are presented.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.12
• /
• pp.1668-1672
• /
• 2000

Nontraumatic, incracranial giant aneurysm has rarely been reported as the cause of the spontaneous subarachnoid hemorrhage in childhood. Multiple, dissecting giant aneurysms on the left middle cerebral artery with sudden onset of headache in a 14-year-old girl were successfully clipped and followed by complete relief of symptoms. The rarity and characteristics of such lesion in childhood and its successful surgical treatment are discussed briefly.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.3
• /
• pp.257-260
• /
• 2014

The etiologies of intracranial artery dissection are various, the exogenous as well as inherited connective tissue disorders. We report on a patient who presented with diffuse subarachnoid hemorrhage who had been suffered from essential thrombocythemia. He was diagnosed to multiple dissecting aneurysms of left superior cerebellar artery, left posterior inferior cerebellar artery and right pericallosal artery and treated with endovascular coil embolization.

• Journal of Korean Neurosurgical Society
• /
• v.49 no.3
• /
• pp.157-162
• /
• 2011

Objective : Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for SAH-induced vasospasm. Methods : Eleven patients with an angiographically confirmed significant vasospasm (>50% vessel narrowing and clinical deterioration) were studied. A total of 54 vessel segments with significant vasospasm were treated by TBA. Digital subtraction angiography was used to confirm the presence of vasospasm, and TBA was performed to dilate vasospastic arteries. Medical and angiographic reports were reviewed to determine technical efficacy and for procedural complications. Results : TBA using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, CA) was successfully accomplished in 88.9% vasospastic segments (48 of 54), namely, in the distal internal carotid artery (100%, n=7), the middle cerebral artery (100%), including the M1 (n=10), M2 (n=10), and M3 segments (n=4), in the vertebral artery (100%, n=2), basilar artery (100%, n=1), and in the anterior cerebral artery (ACA), including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. There were no cases of vessel rupture or thromboembolic complications. GCS at one day after TBA showed an improvement in all patients except one. Conclusion : This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.21 no.1
• /
• pp.77-84
• /
• 2020

■ Objectives This case is to report the effect of Ssanghap-tang on paresthesia of a subarachnoid hemorrhage patient. ■ Methods A male Korean patient was treated with Ssanghap-tang and acupuncture, moxibustion for total 30 days. We observed limbs numbness, circumferences, other symptoms such as weakness and any adverse event. ■ Results After treatment, numeric rating scale of limb numbness was improved to 5 from 8 at admission without any adverse event. However, we could not find any significant differences on hand circumference and limb weakness. ■ Conclusion This case suggests that Ssanghap-tang and acupuncture, moxibustion therapy could be effective in improving paresthesia of subarachnoid hemorrhage patient.

• Journal of Korean Neurosurgical Society
• /
• v.38 no.3
• /
• pp.211-214
• /
• 2005

Objective : Post-traumatic hydrocephalus is a complication of head injury and can present with several different clinical symptoms. However, the developing factors of post-traumatic hydrocephalus and treatment are still not well known. The authors design the study to focus on incidence, causing diseases and treatment of post-traumatic hydrocephalus. Methods : The 789patients of traumatic head injury followed by admission treatment over 7days from Jan. 1997 to Dec. 2001, were divided shunt group and shunt free group. We analyzed age, sex, causing diseases, developing time of hydrocephalus and effects of shunt operation in post-traumatic hydrocephalus. Results : The incidence of post-traumatic hydrocephalus for requiring shunt was 9.2% [64cases]. Chronic hydrocephalus which developed after 14days of injury was higher incidence [51cases]. We found following variables were significantly related to shunt-dependent hydrocephalus : low GCS score at admission, initial CT finding of traumatic subarachnoid hemorrhage and intracerebral hemorrhage [including intraventricular hemorrhage]. The effect of shunt operation was not related with the spinal pressure, but had statistically significant correlation with the response of lumbar drainage. Conclusion : We conclude that development of hydrocephalus after head trauma is related to low GCS score, intracerebral hemorrhage [including intraventricular hemorrhage] and subarachnoid hemorrhage. The effect of preoperative lumbar drainage has a significant role in predicting the result of shunt operation in patient with post-traumatic hydrocephalus.

• Journal of Korean Neurosurgical Society
• /
• v.53 no.3
• /
• pp.187-189
• /
• 2013

We report an unusual case of cerebral aneurysmal subarachnoid hemorrage (SAH) with Fabry's disease. A 42-year-old woman presented with aneurysmal SAH originated from a saccular aneurysm of the right posterior communicating artery. The patient was treated by an endovascular coil embolization of aneurysm. Postoperatively the patient recovered favorably without any neurological deficit. During her admission, the patient had a sign of proteinuria in urine analysis. The pathologic findings of kidney needle biopsy implied nephrosialidosis (mucolipidosis of lysosomal stroage disease), which is consistent with a Fabry's disease. It is uncommon that Fabry's disease is presented with aneurysmal SAH, especially in middle-aged patients, but could be a clinical concern. Further investigations are needed to reveal risk factors, vascular anatomy, and causative mechanisms of Fabry's disease with aneurysmal SAH.