• Journal of Korean Neurosurgical Society
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• v.56 no.5
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• pp.428-430
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• 2014

Isolated traumatic pseudoaneurysms of the basilar artery are extremely rare but often fatal resulting in a mortality rate as high as 50%. A 51-year-old man presented with craniofacial injury after blunt trauma. A brain computed tomography (CT) scan showed thick basal subarachnoid hemorrhage associated with multiple craniofacial fractures, while CT angiography revealed contrast extravasation at the distal basilar artery with pseudoaneurysm formation. After this primary survey, the condition of the patient suddenly deteriorated. Conventional angiography confirmed the contrast extravasation resulted from pseudoaneurysm formation, which was successfully treated with endovascular coil embolization. Decompressive craniectomy and coma therapy with propofol were also performed. However, the patient died on the 7th hospital day because of the poor initial clinical condition. The current case is the first report of acute pseudoaneurysm rupture arising from the basilar artery within the first day after trauma. Our findings suggest the possibility that pseudoaneurysm rupture should be considered if brain CT shows thick traumatic subarachnoid hemorrhage on the basal cistern with a basal skull fracture.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.531-533
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• 2014

We present a case of angiographically confirmed transection of the cisternal segment of the anterior choroidal artery (AChA) associated with a severe head trauma in a 15-year old boy. The initial brain computed tomography scan revealed a diffuse subarachnoid hemorrhage (SAH) and pneumocephalus with multiple skull fractures. Subsequent cerebral angiography clearly demonstrated a complete transection of the AChA at its origin with a massive extravasation of contrast medium as a jet trajectory creating a plume. We speculate that severe blunt traumatic force stretched and tore the left AChA between the internal carotid artery and the optic tract. In a simulation of the patient's brain using a fresh-frozen male cadaver, the AChA is shown to be vulnerable to stretching injury as the ipsilateral optic tract is retracted. We conclude that the arterial injury like an AChA rupture should be considered in the differential diagnosis of severe traumatic SAH.

• The Journal of Korean Medicine
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• v.38 no.4
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• pp.110-117
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• 2017

Objectives: This study aims to evaluate the clinical effectiveness of a Korean medicine treatment on a traumatic spinal cord injury. Metohds : A 44-year-old male patient who had suffered a traumatic spinal cord injury was treated for two months. The effectiveness of complex Korean medicine treatments was measured using the Numeric Rating Scale (NRS) and the Manual Muscle Test (MMT). Result : We found that the NRS of pain caused by numbness was decreased from 7 to 0-1, and the overall motor measured by the MMT was also improved. The patient's walking state was changed from wheelchair ambulation to walker ambulation. Conclusion : Based on this finding, complex Korean medicine treatments may be effective in treating patients' pain, controlling paresthesia, and aiding the recovery function of activities in daily living. However, because of the limitation of our study, further high-quality research should be conducted.

• Journal of Korean Neurosurgical Society
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• v.45 no.3
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• pp.143-150
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• 2009

Objective : The purpose of this study was to investigate the reliable factors influencing the surgical outcome of the patients with traumatic acute subdural hematoma (ASDH) and to improve the functional outcome of these patients. Methods : A total of 256 consecutive patients who underwent surgical intervention for traumatic ASDH between March 1998 and March 2008 were reviewed. We evaluated the influence of perioperative variables on functional recovery and mortality using multivariate logistic regression analysis. Results : Functional recovery was achieved in 42.2% of patients and the overall mortality was 39.8%. Age (OR=4.91, p=0.002), mechanism of injury (OR=3.66, p=0.003), pupillary abnormality (OR=3.73, p=0.003), GCS score on admission (OR=5.64, p=0.000), and intraoperative acute brain swelling (ABS) (OR=3.71, p=0.009) were independent predictors for functional recovery. And preoperative pupillary abnormality (OR=2.60, p=0.023), GCS score (OR=4.66, p=0.000), and intraoperative ABS (OR=4.16, p=0.001) were independent predictors for mortality. Midline shift, thickness and volume of hematoma, type of surgery, and time to surgery showed no independent association with functional recovery, although these variables were correlated with functional recovery in univariate analyses. Conclusion : Functional recovery was more likely to be achieved in patients who were under 40 years of age, victims of motor vehicle collision and having preoperative reactive pupils, higher GCS score and the absence of ABS during surgery. These results would be helpful for neurosurgeon to improve outcomes from traumatic acute subdural hematomas.

• Korean Journal of Bronchoesophagology
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• v.12 no.2
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• pp.35-41
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• 2006

Traumatic pseudoaneurysm of the intracavernous internal carotid artery(ICA) is extremely rare, but it is life threatening condition because of massive recurrent epistaxis. Unfortunately, the prompt diagnosis and treatment of this disease are frequently delayed due to its rarity and variable latent period, so this disease is regarded as a challenge to clinicians. Optimal therapy for this diseases demands rapid suspicion for it and is essential in order to give the best functional outcome with minimizing its morbidity and mortality. The authors present a case of male patient with traumatic pseudoaneurysm of intracavernous ICA accompanying severe epistaxis. This patient was a 37-year-old male with unilateral blindness and recurrent massive epistaxis after suffering trauma to head. Computed tomography, MRI and carotid artery angiogram showed pseudoaneurysm of intracavernous ICA with sphenoid bone fracture. The patient was effectively managed with occlusion of the pseudoaneurysmal circulation by endovascular interventional embolization technique utilizing mechanically detachable tungsten coils.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.38-43
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• 1977

With the adevance of widespread mechanization and high-speed era, the incidence of traumatic rupture of the tracheobronchial tree has been increased considerably. We have experienced these diseased of the 3 cases in our department. The first case was a 25 year old male who was severe dyspneic and subcutaneous emphysema, hemoptysis, and hemopneumothorax of both side were noted. During tracheostomy, it was found that the 2net ring of the trachea was ruptured. No definitive procedure was made on admission. Corrective surgery was performed with end-to-end anastomosis on 31 post-traumatic day. The second case was a 43 year old female who received multiple stab wounds on the anterior neck and it was found that the cricoid cartilage was transected partially. The injured cartilage was approximated with interrupted suture of No. 600 wire. The third case was a 19 year old male who had sustained a compression chest injury without external wound or rib fracture. At five days after trauma, he had suffered from dyspnea, and obstruction of the left main bronchus due to traumatic bronchial rupture was confirmed by means of bronchoscopy and bronchography at two weeks after the trauma. End-to-end anastomosis of the bronchus was performed and the left lung was aerated well. Mild postoperative stenosis of trachea was remained in the first case. Others were uneventful.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.4
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• pp.188-192
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• 2013

Post-traumatic anterior open bite can occur as a result of broken balance among the masticatory muscles. The superior hyoid muscle group retracts the mandible downward and contributes to the anterior open bite. Denervation of the digastric muscle by injection of botulinum toxin type A (BTX-A) can reduce the power of the digastric muscle and help to resolve the post-traumatic anterior open bite. A patient with a bilateral angle fracture had an anterior open bite even after undergoing three operations under general anesthesia and rubber traction. Although the open bite showed some improvement by the repeated operation, the occlusion was still unstable six weeks after the initial treatment. To eliminate the residual anterior open bite, BTX-A was injected into the anterior belly of the digastric muscle. Following injection of BTX-A, the anterior open bite showed immediate improvement. Complication and relapse were not observed during follow-up. Long-standing post-traumatic open bite could be successfully corrected by injection of BTX-A into the anterior belly of the digastric muscle without complication.

• Journal of Acupuncture Research
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• v.31 no.4
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• pp.205-211
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• 2014

Objectives : The purpose of this study is to report the effect of Jungsongouhyul phamacopuncture and electroacupuncture on patients with acute traumatic shoulder pain. Methods : The patients with acute traumatic shoulder pain were diagnosed by blood stasis and divided two groups. One group was treated byJungsongouhyul phamacopuncture. The other group was treated by electroacupuncture. Each group was treated 3 times a week for 2 weeks. The results were measured by visual analog scale(VAS), range of abduction and internal rotation. Results : Two groups had no significant differences before treatment. Jungsongouhyul phamacopuncture group had effects on VAS, range of abduction and internal rotation significantly. Electroacupuncture group also had effects on VAS, range of abduction and internal rotation significantly. But there was no significant differences between two groups. Conclusions : Jungsongouhyul phamacopuncture and electroacupuncture have effect on patients with acute traumatic shoulder pain significantly.

• The Journal of Korean Physical Therapy
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• v.16 no.2
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• pp.72-89
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• 2004

The purposes of this study were to test the effect of balance training and environmental enrichment on motor performance after traumatic cerebellar injury in the rat. Traumatic cerebellar injury was induced by weight drop model and after operation they were housed in individual standard cages for 24 hours. Twenty two Sprague-Dawley rats were randomly assigned into control and experimental groups. The control group was housed in standard cage for 7 days. The experimental group I was housed in standard cage after balance training for 7 days. The experimental group II was housed in environmental enrichment cage after balance training for 7 days. Vestibular drop test and tilting plane test was examined at preoperation, on 1st day after operation and 7th day after operation to the rats. The results of this experiment were as follows: 1. In motor behavioral test, at preoperation and on 1 day after operation, the outcomes were not different among the groups. But on 7th day after operation, the outcomes of group I were better than that in control group, and group II were better than group I. These results suggest that behavioral motor outcome by simultaneously application of balance training and environmental enrichment in traumatic cerebellar injured rats were more improve than that by just balance training.

• Journal of Korean Neurosurgical Society
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• v.39 no.2
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• pp.125-129
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• 2006

Objective : The purpose of this study is to identify any differential point in computerized tomographic[CT] findings between aneurysmal subarachnoid hemorrhage[ASAH] and traumatic subarachnoid hemorrhage[TSAH], which sometimes make us not confident in differentiation. Methods : CT of 142 ASAH and 82 TSAH patients over the last 2 years were retrospectively reviewed. We evaluated the thickness of SAH, the laterality of sylvian cisternal hemorrhage, the location, the number of involved cisterns, and the associated other lesions between two types of SAH. Results : Suprasellar cisterns and sylvian cisterns were most prominently and frequently involved cisterns in ASAH but cortical sulci and sylvian cisterns were most frequently involved in TSAH. Intraventricular and intracerebral hemorrhage were frequently seen in ASAH. Thickness of SAH over 1mm, bilateral sylvian SAH, multiple cisternal SAH were in favor of ASAH. The number of involved cisterns were more frequently seen in ASAH than in TSAH. In ASAH, bilateral sylvian hemorrhages were more frequently seen than in TSAH. Skull fracture, subdural hematoma, subgaleal hematoma, and hemorrhagic contusion were frequently associated with TSAH. Conclusion : As a result of our study, the authors conclude that when IVH, hydrocephalus, thick SAH > 1mm bilateral sylvian SAH, and multiple cisternal SAH are seen in CT, immediate angiography should be performed to rule out cerebral aneurysms whether associated with other traumatic lesions or not.