• Title/Summary/Keyword: acute brain infarction

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Yearly Report on CVA patients (IV) (뇌졸중환자(腦卒中患者)에 대한 연례보고(年例報告)(IV))

  • Shim, Mun-Ki;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.59-74
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    • 1998
  • Clinical observation was done on 272 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1997. 1. The cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage. and transient ischemic attack. The most case of them was the cerebral infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension. and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 7. The common symptoms were motor disability and verbal disturbance. 8 The average time to start physical therapy was 1l.3rd day after stroke in cerebral infarction and it was 15.2th day after stroke in cerebral hemorrhage. 9. The common complications were urinary tract infection, pneumonia, myocardial infarction. 10. Hypercholesterolemia and hypertriglyceridemia are usually found more frequently in cerebral infarction than in hemorrhage. 11. In acute or subacute stage, the methods of smoothening the flow of ki(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. and in recovering stage, the methods of replenishing ki(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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Complications amd Mortality After Coronary Artery Bypass Graft Surgery; Collective Review of 61 Cases (관상동맥우회수술후 합병증과 사망율에 대한 임상적 고찰;61례 보고)

  • 조건현
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.526-531
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    • 1993
  • Sixty-one consecutive patients with coronary artery bypass graft for myocardial revascularization were retrospectively reviewed to analyze various pattern of postoperative complication and death during hospital stay from Nov. 1988 to Oct. 1992. Fortytwo of the patients were male and nineteen female. The mean age was 56 and 51 years in male and female. Preoperative diagnosises were unstable angina in 14 of patients, stable angina in 28, postmyocardial infarction state in 15, and state of failed percutaneous transluminal coronary angioplasty in 4. 141 stenosed coronary arteries were bypassed with use of 20 pedicled internal mammary artery and 124 reversed saphenous vein grafts. Postoperative complications and perioperative death were as follows: 1. Of 61 patients undergoing operation, peri and postoperative over all complication occured in 15 patients [ 25% ]; newly developed myocardial infarction in 4, intractable cardiac arrhythmia including atrial fibrillation and frequent ventricular premature contraction in 3, bleeding from gastrointestinal tract in 2, persistent vegetative state as a sequele of brain hypoxia in 1, wound necrosis in 1, left hemidiaphragmatic palsy in 3 and poor blood flow through graft in 2. 2. Operative mortality was 8%[5 patients]. 3 out of these died in operating room; 1 patient by bleeding from rupture of calcified aortic wall, 1 by air embolism through left atrial vent catheter, 1 by low cardiac output syndrome. 2 patients died during hospital stay; 1 by acute respiratory distress syndrome with multiuple organ failure, 1 by brain death after delayed diagnosis of pericardial tamponade.

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Orungsan(Goreisan) Application in Neurosurgical Field: Review of the Studies Reported in the 20th Annual Meeting of Kampo Medicine Association of the Japan Neurosurgical Society (뇌혈관질환에 대한 오령산(五苓散) 치료의 일본 유용성 - 2011년 제20회 일본뇌신경외과한방의학회 학술대회 발표논문을 중심으로-)

  • Jang, In-soo;Kwon, Seung-won;Kim, Kying-wook
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.12 no.1
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    • pp.1-7
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    • 2011
  • Objectives : The purpose is to discuss the clinical applications of Orungsan(Goreisan: 五苓散) as an alternative management for increased intracranial pressure in the field of neurosurgery in Japan. Methods and Results : Attention has focused on Kampo medicine(traditional Japanese medicine) for some cerebral disease including chronic subdural hematoma(CSDH) and cerebral infarction in Japan. Orungsan and one of its classes, Sirungtang(Saireto: 柴苓湯) are well known their effects on brain edema. After some studies of Orungsan has the anti-edemic effects by the inhibition of aquaporin, this herbal medicine has been used widely in the neurosurgery field in Japan. It is high time to think about where we are and we go ahead for the progress and the integration in medicine. We have reviewed the studies using Orungsan or Sirungtang, that was reported at the 20th annual meeting of 'the Japan society for Kampo medicine and neurological surgery' was held on November 5, 2011 in Tokyo. Fifteen studies related with Orungsan or Sirungtang were reported among all 32 studies at the meeting. Orungsan in ten, and Sirungtang in five among 14 studies contained specific clinical case. In the aspects of disease, thirteen papers were related with SDH, including CSDH(11), SSDH(1), aneurism clipping for SDH prevention(1), and one was acute cerebral infarction and one was multiple metastatic brain tumor. In the report style, case control study was 7(mostly retrospective), and the case report was 8. Conclusions : Orungsan may be plausible to be an alternative method to reduce brain edema after SDH and other brain injury in the field of neurosurgery.

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Isolated Bilateral Midbrain Infarction in A Healthy Female Adolescent: A Case Report

  • Dong Ho Yoo;Byunghoon Lee;Yong Beom Shin;Myung-Jun Shin;Jin A Yoon;Sang Hun Kim
    • Physical Therapy Rehabilitation Science
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    • v.12 no.3
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    • pp.207-213
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    • 2023
  • Objective: The purpose of this study was to understand the complex anatomical structure and function of the midbrain to better understand the patient's symptoms and plan effective treatment including pharmacological and rehabilitation interventions. Design: A single case study Methods: A 17-year-old girl presented with acute onset of drowsiness, gait disturbance, mutism, and ptosis. Physical examination revealed postural instability, rigidity of all limbs, and limitations in extraocular movement. The brain MRI revealed an isolated acute infarction in the bilateral midbrain. Considering the location of the infarction, the presenting symptoms were the result of an impairment of the dopaminergic pathway in addition to lesions in the nuclei of the oculomotor nerve. Levodopa/carbidopa was prescribed. And the intensive and comprehensive rehabilitation program was done. Results: As a result of the study, through comprehensive intervention, which encompassed assessments such as the manual muscle test, Korean Modified Barthel Index score, and Trail-making test, significant enhancements in the patient's condition were observed. These findings provide evidence supporting the effectiveness of the intervention in promoting the patient's physical functioning and overall well-being. Conclusions: The results of this case highlight the significance of comprehending the intricate anatomical structure and functional aspects of the midbrain, which led us to approach appropriate pharmacological and rehabilitation interventions. Through active communication among the medical team, we were able to establish a therapeutic plan, which demonstrated that effective treatment can be achieved.

Sixth Cranial Nerve Palsy and Vertigo Caused by Vertebrobasilar Insufficiency

  • Paik, Seung Won;Yang, Hui Joon;Seo, Young Joon
    • Korean Journal of Audiology
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    • v.24 no.3
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    • pp.157-160
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    • 2020
  • A 38-year-old woman presented with a week's history of binocular horizontal double vision and acute vertigo with gaze-induced nystagmus. We considered a diagnosis of one of the six syndromes of the sixth cranial nerve and evaluated several causes. She had history of severe anemia, vitamin B12 deficiency, and hypertension. Magnetic resonance imaging with angiography showed stenosis of the right vertebral artery and hyperintensity on both basal ganglia. As we describe here, we should consider vertebrobasilar insufficiency as a cause for sixth cranial nerve palsy if a patient has high risk for microvascular ischemia, even in the absence of acute brain hemorrhage or infarction.

Sixth Cranial Nerve Palsy and Vertigo Caused by Vertebrobasilar Insufficiency

  • Paik, Seung Won;Yang, Hui Joon;Seo, Young Joon
    • Journal of Audiology & Otology
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    • v.24 no.3
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    • pp.157-160
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    • 2020
  • A 38-year-old woman presented with a week's history of binocular horizontal double vision and acute vertigo with gaze-induced nystagmus. We considered a diagnosis of one of the six syndromes of the sixth cranial nerve and evaluated several causes. She had history of severe anemia, vitamin B12 deficiency, and hypertension. Magnetic resonance imaging with angiography showed stenosis of the right vertebral artery and hyperintensity on both basal ganglia. As we describe here, we should consider vertebrobasilar insufficiency as a cause for sixth cranial nerve palsy if a patient has high risk for microvascular ischemia, even in the absence of acute brain hemorrhage or infarction.

Individual approach in the recanalization treatment of the acute ischemic brain stroke according to the various MR findings in hyperacute stage

  • Y. Jang;Lee, D.;Kim, H.;Lee, J.;Park, C.G.;Lee, H.K.;Kim, S.;D. Suh
    • Proceedings of the KSMRM Conference
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    • 2003.10a
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    • pp.98-98
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    • 2003
  • We will present various MR findings of hyperacute ischemic stroke with our own experiences in the management of the patients according to the findings. 대상 및 방법: A total of 441 patients were underwent 'acute stroke MR' imaging protocol between Mar. 2001 and Jun. 2003. The protocol included initial T2-weighted image (WI), diffusion WI (DWI, b=2000), time-of-flight (TOF) MR angiography (MRA), and pefusion WI(PWI), and follow-up T2WI, DWI, TOF MRA, and neck vessel contrast-enhanced MRA obtained three to five days after the insult. Among them, we retrospectively reviewed the MR findings and clinical courses of 193 patients with anterior circulation territorial infarction. Those ICA and MCA lesions were divided into six and five groups respectively according to the level and mechanism of the occlusion. PWI findings can be another factor in the management planning.

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Transient Global Aphasia with Hemiparesis Following Cerebral Angiography : Relationship to Blood Brain Barrier Disruption

  • Kim, Dong-Ha;Choi, Chang-Hwa;Lee, Jung-Hwan;Lee, Jae-Il
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.524-527
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    • 2010
  • Temporary disruption of the blood-brain barrier (BBB) after cerebral angiography is presumably caused by nonionic radiographic contrast medium (CM). We hereby report a case of 58-year-old woman who developed decreased mentality, global aphasia and aggravated right hemiparesis after cerebral angiography. Brain CT examination demonstrated gyriform enhancement throughout the left cerebral cortex and thalamus. MR diffusion did not reveal acute infarction. MR angiography did not show any stenosis, spasm or occlusion at the major cerebral vessels. Follow-up CT scan after 1 day did not show any gyriform enhancement. Worsened neurologic signs and symptoms were improved completely after 7 days. In the present study, disruption of the BBB with contrast medium after angiography seems to be the causative factor of transient neurologic deterioration.

A case of Early Neurological Recovery from Stroke by Recannalization in Early Stage (조기 혈관 재개통으로 뇌졸중 초기에 회복을 보인 환자 1예)

  • Kim, Jin-ah;Park, Jung-mi
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.6 no.1
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    • pp.63-68
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    • 2005
  • Objective: The purpose of this case study is to show a case of early neurological recovery from stroke by recannalization. Methods: The patient was admitted from 12 July, 2004 to 26 July, 2004. The patient received Herb-Medication and Acupuncture Therapy. Brain MRI and Tc-99m HM-PAO brain SPECT was used to diagnose and prognose. Results: The patient fully recovered within a few hours. She was diagnosed as acute infarction in Lt. BG by using brain MRI. Tc-99m HM-PAO brain SPECT showed focal increased perfusion at Lt. BG. Conclusions: We suggest that the important thing to recovery from stroke is recannalization of cerebral arteries in early stage.

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One case Treated Cerebral Infarction with Aphasia by Jihwangumja (지황음자(地黃飮子)를 투여(投與)한 중풍(中風) 실어증(失語症) 환자 치험1례)

  • Shin Woo-Jin;Hong Hyun-Woo;Kim Ji-Yun;Jeong Jae-Ook;Seo Sang-Ho;Kim Jong-Hwan;Jang Ja-Won;Park Dong-Il
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1014-1022
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    • 2003
  • Aphasia is speech disorder caused by injuries on the speech nerve center. It usually occur due to a disease in the right cerebral cortex and is divided into the various aphasia such as Global aphasia, Broca's aphasia, Wernicke's aphasia, conduction aphasia, Anomic aphasia, etc. Jihwangumja is used the cerebral infarction with Aphasia due to deficiency syndrome of kidneys. The purpose of this study is to examine the efficacy of oriental treatment for cerebral infarction with aphasia by Jihwangumsa. In the hospital, the patient showed the symptoms of mental disorder, Rt. hemiparesis G3/G4, aphasia, chest discomfort, obstipation, frequent urination, etc. The case showed that acute infarction on Lt. fronto-temporo-parietal lobe in Brain-CT. We identified the patient's clinical conditions and treated accordingly. As a result of treatment, symptoms were markedly improved and he was discharged. Further elaboration of oriental diagnostic classification could possibly lead to the fundamental treatment.

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