• 제목/요약/키워드: Subcortical

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언어치료와 한방치료를 병행한 중풍 피질하실어증 치험 1례(例) (A Case of Subcortical Aphasic Stroke Treated with Speech-Language Therapy and Korean Medical Therapy)

  • 형례창;여진주;유경;서의석;장인수
    • 대한한방내과학회지
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    • 제26권3호
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    • pp.733-740
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    • 2005
  • Subcortical Aphasia is not among the typical eight types of aphasia. It is characterized as cerebral infarction or hemorrhage occurring in the region of the left basal ganglia internal capsule, accompanied with ventrical rounding and white matter. Subcortical aphasia is similar to transcortical aphasia in its symptom of repetition, and classification is difficult. Language ability can change rapidly over several months so a patient's convalescence is unpredictable. Because of the peculiarities of subcortical aphasia there are many conflicting hypotheses. Various clinical approaches and medical treatments for speech disorder(aphasia) have been presented. In Korean medicine, there are many studies about speech disorder, but few reports are related to subcortical aphasia. An aphasic stroke patient who was treated with acupuncture, herbal medicine(Jihwangumja), and speech-language therapy is here reported. Significant improvement in language abilities was seen over three months. Further clinical study of subcortical aphasia is needed.

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A Subcortical Anaplastic Meningioma

  • Kim, Chang-Hyun;Park, Seong-Hyun;Hwang, Jeong-Hyun;Hamm, In-Suk
    • Journal of Korean Neurosurgical Society
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    • 제37권3호
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    • pp.235-237
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    • 2005
  • Meningioma without dural attachment usually occurs in the intraventricular region, the pineal region, and the sylvian fissure. However, subcortical meningioma located far from such locations is extremely rare. The authors report a case of subcortical anaplastic meningioma without any dural attachment in a 41-year-old woman.

말라리아 후유증으로 초래된 피질하성 치매 1례 (A Case of Subcortical Dementia After Cerebral Malaria)

  • 정효경;이영호;정영조;김수지;박병관
    • 생물정신의학
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    • 제2권2호
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    • pp.301-305
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    • 1995
  • Subcortical dementia may occur as a complication of cerebral malaria via deep white matter demyelination with encephalitis and diffuse small vessel vasculitis. In subcortical dementia, impairment in attention and frontal executive function are predominant. Patients are often inert, indifferent, and uninterested. They appear characteristically 'slowed up' with a marked deficit in the retrieval of information. Changes in mood, personality, and social conduct are very common. We describe a case of subcortical dementia, who has definite changes in brain MRI after cerebral malaria.

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Diversity of Subcortical Arthropod Communities in Tropical and Temperate Forests

  • 조재천
    • Animal cells and systems
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    • 제1권4호
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    • pp.577-581
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    • 1997
  • Species diversity of subcortical arthropod communities were assessed in two tropical regions and two temperate regions. In the tropics, communities of subcortical arthropods were more diverse in La Selva, Costa Rica, than on Barro Colorado Island, Panama. Costa Rican communties yielses higher values of both Shannon and Simpson diversity indices than Panamanian communities. Compared to Panamanian communities, Costa Rican ones supported higher measures of both species richness and evenness. Between the two temperate regions, communities of subcortical arthropods in Korea scored consistently higher values of both Shannon and Simpson indices than the ones in eastern Massachusetts, U.S.A. When individual diversity components were compared, however, Korean communities yielded exceptionally high evenness measures but lower species richness than the communities in the U.S.A. Unusually high evenness values of Korean subcortical arthropods were due to extremely low population densities of all component species.

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피질하 혈관성치매의 진단, 치료 및 예방 : 1례 보고와 함께 (Diagnosis, Treatment and Prevention of Subcortical Vascular Dementia with a Case Report)

  • 최성훈;구세광;전우현;백경민;한창현;전원경;이영준
    • 대한예방한의학회지
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    • 제14권3호
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    • pp.63-75
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    • 2010
  • Vascular dementia(VaD) is currently considered to be the second most common type of dementia. VaD is not a single diagnostic entity, but a heterogeneous syndrome which encompasses several clinicopathological forms of dementia resulting from cerebrovascular diseases. A common form of VaD is subcortical VaD which is characterized by lacunar infarcts and deep white matter changes, leading to a progressive decline in memory and cognitive function. The neuropsychological and cognitive profiles of subcortical VaD have been reported relatively homogeneous. At present, subcortical vascular dementia is regarded as the most important subtype of VaD with getting the attention of vascular dementia. The aims of this study are to discuss the concept of subcortical VaD and its importance focusing on diagnosis, prevention and treatment with a case report.

Subcortical Ischemic Change as a Predictor of Driving Cessation in the Elderly

  • Jang, Mi;Hong, Chang Hyung;Kim, Hyun-Chung;Choi, Seong Hye;Seo, Sang Won;Kim, Seong Yoon;Na, Duk L.;Lee, Yunhwan;Chang, Ki Jung;Roh, Hyun Woong;Son, Sang Joon
    • Psychiatry investigation
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    • 제15권12호
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    • pp.1162-1167
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    • 2018
  • Objective Motor, perceptual, and cognitive functions are known to affect driving competence. Subcortical ischemic changes on brain magnetic resonance imaging (MRI) can reflect reduction in cognitive and motor performance. However, few studies have reported the relationship between subcortical ischemic changes and driving competence of the elderly. Thus, the objective of this study was to investigate the association between subcortical ischemic changes on MRI and driving abilities of the elderly. Methods Participants (n=540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort. Each participant underwent MRI scan and interview for driving capacity categorized into 'now driving' and 'driving cessation (driven before, not driving now)'. Participants were divided into three groups (mild, n=389; moderate, n=116; and severe, n=35) depending on the degree of white matter hyperintensity (WMH) on MRI at baseline. Driving status was evaluated at follow-up. Statistical analyses were conducted using ${\chi}^2$ test, analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE). Results In SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive or motor dysfunction (${\beta}=-0.110$, p<0.001). In GEE models after controlling for age, sex, education, cognitive, and motor dysfunction, more severe change in the degree of WMH was associated with faster change from 'now driving' state to 'driving cessation' state over time in the elderly (${\beta}=-0.508$, p<0.001). Conclusion In both cross-sectional and longitudinal results, the degree of subcortical ischemic change on MRI might predict driving cessation in the elderly.

양극성장애 환자의 뇌자기공명영상에서 보이는 피질하 고신호광도의 임상적 상관변수에 관한 예비적 연구 (Clinical Correlates of Subcortical Hyperintensities on Magnetic Resonance Imaging in Patients with Bipolar Disorder : Preliminary Study)

  • 윤대현;권준수;한문희;장기현
    • 생물정신의학
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    • 제4권1호
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    • pp.60-66
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    • 1997
  • 서울대학교병원 신경정신과에 입원하여 뇌자기공명영상촬영을 시행한 32명(남자 18명, 여자 12명)의 양극성장애환자를 대상으로 피질하 $T_2$ 강조-고신호광도의 임상적 변수에 관한 연구를 시행하여 다음과 같은 결과를 얻었다. 1) 32명의 환자중 피질하 고신호광도를 보인 환자의 수는 7명(21.8%)이었고, 8명의 40세 이상의 환자중에서는 5명(62%)이 고신호광도를 보였다. 2) 피질하 고신호광도를 보인 환자군이 그렇지 않은 군에 비해 통계적으로 유의한 수준으로 연령이 높았고(p<0.01), 연령과 정량화된 피질하 고신호광도 점수와의 상관분석에서도 유의한 양의 상관관계를 보였다(r=0.51, p<0.01). 3) 피질하 고신호광도를 보인 환자군에서 정신병적 증상의 빈도는 증가되고(p=0.06), 정동장애 가족력의 빈도는 감소한 경향을 보였다(p=0.01). 이상의 결과는 발병연령이 늦은 양극성장애 환자의 상당수에서 발견되는 피질하 고신호광도가, 유전적요인에 주로 영향을 받는 조기 발병군과는 다른 경과나 임상양상 등을 보이는 만발성 양극성장애 환자의 원인적 요소일 수 있다는 가설을 뒷받침해주는 소견이다.

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효과적인 대뇌 직접피질자극 검사 및 피질하자극 검사의 술기에 관한 기술적 고찰 (Technical Considerations of Effective Direct Cortical and Subcortical Stimulation)

  • 임성혁;장민환
    • 대한임상검사과학회지
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    • 제54권2호
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    • pp.157-162
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    • 2022
  • 본 술기의 목적은 운동피질 주변에 발생한 뇌종양 환자의 수술에서 TceMEP로 인해 발생하는 위양성을 방지하고 수술 중 운동영역의 정확한 매핑과 피질척수로 보존하기 위함이다. 또한 검사과정에서 발생하는 시행착오를 줄이고 검사시간을 최소화하여 검사결과에 대한 빠른 피드백으로 수술하는 의사에게 정확한 정보를 전달함에 있다. 본 술기의 가장 중요한 요소는 첫번째로 일정 세기의 자극역치로 검사해야 하는 것과 두번째로는 일정 수준의 마취농도를 적정 수준으로 유지하는 것이 수술 중 발생하는 위양성을 막는 기본적이 요소이다. 세번째로는 수술하는 반대쪽 부위에 다중 채널을 이용한 기록전극의 설치로 최대한 많은 근육에서 TceMEP파형과 집접피질자극 및 직접피질하 자극에 대한 반응을 측정하는 것이다. 이런 조건들이 수술이 진행되는 동안 원활하게 유지된다면 검사에서 오는 위양성이 아닌 그 밖의 요인들에서 발생할 수 있는 원인들을 예측할 수 있다.

Clinical impact of cerebral microbleeds on cognition in patients with CADASIL

  • Lee, Jung Seok;Ko, Keun Hyuk;Oh, Jung-Hwan;Choi, Jay Chol;Kim, Joong-Goo
    • Journal of Medicine and Life Science
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    • 제15권2호
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    • pp.89-94
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    • 2018
  • Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is inherited microangiopathy caused by mutations in the Notch3 gene. Typical findings from brain magnetic resonance imaging (MRI) include subcortical lacunes, extensive white matter change and cerebral microbleeds(CMBs). CMBs are indicative of bleeding-prone microangiopathy. Despite some studies investigating the association between lacunes and cognitive dysfunction in CADASIL, few studies have examined the relationship between cognitive dysfunction and CMBs. We sought to assess whether CMBs are associated with cognitive dysfunction in CADASIL. This study enrolled 83 consecutive patients with CADASIL between April 2012 and January 2014. Their degree of cognitive dysfunction was assessed by the Korean version of the CERAD neuropsychological assessment battery, digit span test, and the Stroop test. A 3.0-T MRI was used to obtain T1-weighted, fluid-attenuated inversion recovery, and susceptibility weighted images. In multiple logistic regression analysis, the grade of CMBs influenced tests of memory dysfunction (p=0.003). Three or more lacunes correlated with dysfunction in the executive domain (p=0.013) and attention domain (p=0.005). White matter hyperintensity (WMH) was an independent predictor of executive dysfunction (p=0.001). These findings suggest that in addition to lacunes, CMBs and WMHs may be useful imaging markers to associated with cognitive dysfunction in CADASIL.

70대의 성별에 따른 피질하부 차이 비교 (Comparison of Differences in Subcortical between Men and Women in their Seventies)

  • 안병주;박혜미;김주연;이정환
    • 한국방사선학회논문지
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    • 제14권5호
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    • pp.585-595
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    • 2020
  • 자기 공명 영상(MRI)은 인간의 신경계 장애에서 뇌 구조의 변화를 검사하는 중요한 기술이다. 뇌 발달은 매우 복잡한 과정이며, 신경 생성과 유전자 프로그램의 영향을 받게 된다. 나이가 들어감에 따라 뇌의 다양한 구조 영역이 변화하면서 뇌 질환 형성에 기여하게 되며, 건강한 뇌의 발달에 영향을 미치는 다양한 변수 중 성별은 가장 큰 영향을 주는 요인 중 하나이다. 영상 데이터는 FSL(FMRIB software library)에서 제공하는 SIENAX, FIRST, 정점분석(Vertex Analysis)과 같은 다양한 프로그램을 통해 분석이 수행되었다. 우리의 결과는 특정 연령대의 피질하부영역에서 유의한 성별 관련 차이가 관찰되었음을 보여주고 있다. 성별과 볼륨간의 이러한 변화 정도 차이의 크기는 조사 된 영역에 따라 다르게 나타나고 있다. 이 연구에서 우리는 각 성별간 피질하부영역의 구조 분석을 위해 고해상도 3T MRI를 사용하였다. 또한, 정점 분석은 각 성별간의 피질 구조에서 체적 차이를 시각화하는데 사용되었다. 이 연구는 70대 그룹으로 제한되어 있으며, 향후 더 넓은 연령대를 대상으로 추가 연구가 필요하다.