• 제목/요약/키워드: acute stroke

검색결과 537건 처리시간 0.023초

Ginkgolide B Modulates BDNF Expression in Acute Ischemic Stroke

  • Wei, Hu;Sun, Tao;Tian, Yanghua;Wang, Kai
    • Journal of Korean Neurosurgical Society
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    • 제60권4호
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    • pp.391-396
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    • 2017
  • Objective : To investigate the neuroprotective effects of Ginkgolide B (GB) against ischemic stroke-induced injury in vivo and in vitro, and further explore the possible mechanisms concerned. Methods : Transient middle cerebral artery occlusion (tMCAO) mice and oxygen-glucose deprivation/reoxygenation (OGD/R)-treated N2a cells were used to explore the neuroprotective effects of GB. The expression of brain-derived neurotrophic factor (BDNF) was detected via Western blot and qRT-PCR. Results : GB treatment (4 mg/kg, i. p., bid) significantly reduced neurological deficits, water content, and cerebral infarct volume in tMCAO mice. GB also significantly increased Bcl-2/Bax ratio, reduced the expression of caspase-3, and protected against OGD/R-induced neuronal apoptosis. Meanwhile, GB caused the up-regulation of BDNF protein in vivo and in vitro. Conclusion : Our data suggest that GB might protect the brain against ischemic insult partly via modulating BDNF expression.

Isolated Distal leg Weakness due to a Small Cerebral Infarction Masquerading as a Spinal Lesion

  • Han, In-Bo;Ahn, Jung-Yang;Chung, Young-Sun;Chung, Sang-Sup
    • Journal of Korean Neurosurgical Society
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    • 제41권3호
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    • pp.182-185
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    • 2007
  • Acute stroke with isolated monoparesis manifesting as distal weakness of a single lower extremity has rarely been described. We report two patients with small cortical infarction who had distal weakness of a single lower extremity. In both cases, diffusion-weighted image [DWI] was used to detect small lesions in the contralateral cortex. These cases illustrate that small cortical infarction can cause isolated monoparesis limited to distal part of the leg and it may be misdiagnosed as spinal lesions, especially when lower back pain and transient sensory symptoms are accompanied. In case of the abrupt onset of weakness limited to one lower limb, the possibility of stroke should be considered and careful attention to identify cortical lesions using magnetic resonance imaging, especially DWI is required.

Performance of Activities of Daily Living in Adult Hemiplegic Patients (성인 편마비 환자의 일상생활동작 수행능력 평가)

  • Kim, Sang-Su;Kwon, Mi-Ji
    • Journal of Korean Physical Therapy Science
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    • 제2권3호
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    • pp.645-651
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    • 1995
  • The purpose of study was that the functional gains achieved by stroke patients after rehabilitation in the acute phase have been documented. Sixty stroke inpatients who were at least 3.57 month postonset participated;32 males and 28 females;mean age, 57.4 years. By the classification of diagnosis, 20 subjects were cerebral infarction and 27 subjects were cerebral hemorrhage. Activities of daily living(ADL) performance was investigated using the Klein-Bell ADL Scale. ADL test was practiced within physical therapy room. The outcome variables were first analyzed using frequency statistics. The functional gains of the patients with sex and hemiplegic site were then using an ANOVA. Mean score of dressing, elimination, mobility, bathing/hygiene, eating, and telephone use, 26.6, 56.0, 41.4, 36.5, 82.0, and 56.7. Mean score of total, 43.0. There was no significant difference in sex and hemiplegic site.

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Carotidynia presenting with acute ischemic stroke after carotid sinus massage

  • Kwak, Hyo Sung;Chung, Gyung Ho;Lee, Chan-Hyuk;Jeong, Seul-Ki;Ryu, Han Uk
    • Annals of Clinical Neurophysiology
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    • 제19권1호
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    • pp.46-49
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    • 2017
  • Carotidynia is characterized by unilateral neck pain around the carotid artery. We describe a 50-year-old woman who presented with transient left-side weakness and right-side neck pain. She frequently massaged the uncomfortable neck area during the symptomatic course of the condition. Magnetic resonance imaging revealed multifocal cerebral infarctions and a carotid intramural thrombus ipsilateral to the carotidynia.Long-term carotidynia might result in the involvement of an intramural thrombus and intimal disruption, and ischemic stroke after carotidynia may be provoked by carotid sinus massage.

Current Opinion on Endovascular Therapy for Emergent Large Vessel Occlusion Due to Underlying Intracranial Atherosclerotic Stenosis

  • Dong-Hun Kang;Woong Yoon
    • Korean Journal of Radiology
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    • 제20권5호
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    • pp.739-748
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    • 2019
  • For recanalization of emergent large vessel occlusions (ELVOs), endovascular therapy (EVT) using newer devices, such as a stent retriever and large-bore catheter, has shown better patient outcomes compared with intravenous recombinant tissue plasminogen activator only. Intracranial atherosclerotic stenosis (ICAS) is a major cause of acute ischemic stroke, the incidence of which is rising worldwide. Thus, it is not rare to encounter underlying ICAS during EVT procedures, particularly in Asian countries. ELVO due to underlying ICAS is often related to EVT procedure failure or complications, which can lead to poor functional recovery. However, information regarding EVT for this type of stroke is lacking because large clinical trials have been largely based on Western populations. In this review, we discuss the unique pathologic basis of ELVO with underlying ICAS, which may complicate EVT procedures. Moreover, we review EVT data for patients with ELVO due to underlying ICAS and suggest an optimal endovascular recanalization strategy based on the existing literature. Finally, we present future perspectives on this subject.

Significances and Outcomes of Mechanical Thrombectomy for Acute Infarction in Very Elderly Patients : A Single Center Experience

  • Kim, Dong Hun;Kim, Sang Uk;Sung, Jae Hoon;Lee, Dong Hoon;Yi, Ho Jun;Lee, Sang Won
    • Journal of Korean Neurosurgical Society
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    • 제60권6호
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    • pp.654-660
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    • 2017
  • Objective : Mechanical thrombectomy is increasingly being used for the treatment of acute ischemic stroke. The population over 80 years of age is growing, and many of these patients have acute infarction; however, these patients are often excluded from clinical trials, so the aim of this study was to compare the functional outcomes and complication rates in very elderly patients (age ${\geq}80$ years) and aged patients (60-79 years) treated with mechanical thrombectomy. Methods : Between January 2010 and June 2015, we retrospectively reviewed 113 senior patients (over 60 years old) treated at our institution for acute ischemic stroke with mechanical thrombectomy. They were divided into a very elderly (${\geq}80$ years) and aged (60-79 years) group, with comparisons in recanalization rates, complications, death and disability on discharge be reported. Results : The mean age was 70.3 years in the aged group and 83.4 years in the very elderly group. Elderly patients had higher rates of mechanical thrombectomy failure than the younger group (40% vs. 14%; odds ratio [OR] 4.1; 95% confidence interval [CI] 1.4-11.9; p=0.012). Results from thrombolysis in cerebral ischemia and modified Rankin scale at discharge were worse in the older group (p=0.005 and 0.023 respectively). There were no differences in mortality rate or other complications, but infarction progression rates were significantly higher in the very elderly group. (15% vs. 2.2%; OR 8.0; 95% CI 1.2-51.7; p=0.038). The majority (92.3%) of the patients who failed in aged group were not successful after several trials. However, in half (4 of 8) of the very elderly group, the occlusion site could not be accessed. Conclusion : Patients older than 80 years of age undergoing mechanical thrombectomy for acute infarction were more difficult to recanalize due to inaccessible occlusion sites and had a higher rate of infarction progression, However, mortality and other complications were similar to those in younger patients.

Motor Evoked Potential Study with Magnetic Stimulation in Ischemic Stroke Patients (허혈성 뇌졸중 환자에서 Magnetic Stimulation에 의한 운동유발전위 반응)

  • Kim, Seong-Min;Suh, Sang-Dug;Lee, Jun;Hah, Jung-Sang
    • Journal of Yeungnam Medical Science
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    • 제11권2호
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    • pp.248-261
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    • 1994
  • This study was undertaken to evaluate the clinical usefulness of magnetic motor evoked potential (MEP) in the diagnosis of stroke and predicting the motor improvement following stroke. The cortical, cervical and lumbar stimulations were performed in the case of 24 healthy controls and 24 ischemic stroke patients. The central motor conduction time (CMCT) was represented by the difference of latency to a target muscle between after transcranial stimulation and after cervical or lumbar stimulation. There was no case showing no response in controls. But in 11 out of 24 ischemic patients, we could not get cortical MEP. Mean CMCT of abductor pollicis brevis muscle was not significantly different in controls and stroke patients in whom MEPs were recorded. There were significant differences between mean CMCT of normal controls and that of stroke patients showing MEPs in AH Muscle. MEP Results from testing the stroke patients were correlated with site of lesion, degree of motor weakness and motor improvement after 1 to 2 months. These results suggest that magnetic MEP is easy and useful in electrophysiological test of central motor pathway and is useful indicator for representing the motor weakness and predicting the motor outcome in acute ischemic stroke patients.

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TOAST Distribution of Ischemic Stroke Patients Admitted to Oriental Hospitals (한방 의료기관에 입원한 허혈성 뇌졸중 환자의 아형 분포)

  • Lee, Jung-Sup;Ko, Mi-Mi;Lee, Ju-Ah;Kang, Byoung-Kab;Cha, Min-Ho;Oh, Dal-Seok;Bang, Ok-Sun
    • The Journal of Korean Medicine
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    • 제31권5호
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    • pp.82-89
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    • 2010
  • Objectives: The aim of this study was to determine distribution patterns of TOAST subtypes of ischemic stroke patients admitted to oriental hospitals and to get a better understanding of present conditions in oriental medicine by comparing with the Korea stroke registry (KSR), the largest and representative data. Methods: Clinical data were collected from acute ischemic stoke patients. MRI studies including vascular images were performed in all cases. TOAST criteria were used to determine subtypes of ischemic stroke patients. According to the duration from disease onset to hospital admission time, patients were assigned to 3 groups (Group I0 to 3 d, Group II4 to 7 d, Group III8 to 28 d) and the distribution of TOAST subtypes were compared among these three groups. Results: We collected 514 sets of clinical data from 10 oriental hospitals between May 2007 and September 2009. Small vessel occlusion (SVO) subtype was the most common (57.62%), followed by large artery atherosclerosis (LAA, 29.98%). Compared with TOAST distribution of KSR, the proportion of ischemic stroke patients with SVO subtype was higher than that of KSR. On the other hand the proportion of patients with stroke of undetermined etiology (SUE) was lower. Distributions of SVO, LAA and cardioembolism (CE) in group were I 66.4%, 23.8% and 8.9%, respectively; those in group IIIwere 51.03%, 34.71% and 11.57%, respectively. Conclusions: In oriental hospitals, the proportion of ischemic stroke patients diagnosed as SVO type was higher than that of KSR. At early stage (from onset to 2 d) proportion of SVO was very high, however after 7 days from onset it decreased with concomitant increases in proportions of LAA and CE. These phenomena may be due to the facts that 1) at early stage emergency treatments are limited in oriental hospitals, 2) after early stage many patients prefer oriental treatments, including rehabilitation.

Phosphodiesterase-5 Inhibitor Attenuates Anxious Phenotypes and Movement Disorder Induced by Mild Ischemic Stroke in Rats

  • Yu, Yeon Hee;Kim, Seong-Wook;Kang, Juhyeon;Song, Yejin;Im, yHyuna;Kim, Seo Jeong;Yoo, Dae Young;Lee, Man-Ryul;Park, Dae-Kyoon;Oh, Jae Sang;Kim, Duk-Soo
    • Journal of Korean Neurosurgical Society
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    • 제65권5호
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    • pp.665-679
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    • 2022
  • Objective : Patients with mild ischemic stroke experience various sequela and residual symptoms, such as anxious behavior and deficits in movement. Few approaches have been proved to be effective and safe therapeutic approaches for patients with mild ischemic stroke by acute stroke. Sildenafil (SIL), a phosphodiesterase-5 inhibitor (PDE5i), is a known remedy for neurodegenerative disorders and vascular dementia through its angiogenesis and neurogenesis effects. In this study, we investigated the efficacy of PDE5i in the emotional and behavioral abnormalities in rats with mild ischemic stroke. Methods : We divided the rats into four groups as follows (n=20, respectively) : group 1, naïve; group 2, middle cerebral artery occlusion (MCAo30); group 3, MCAo30+SIL-pre; and group 4, MCAo30+SIL-post. In the case of drug administration groups, single dose of PDE5i (sildenafil citrate, 20 mg/kg) was given at 30-minute before and after reperfusion of MCAo in rats. After surgery, we investigated and confirmed the therapeutic effect of sildenafil on histology, immunofluorescence, behavioral assays and neural oscillations. Results : Sildenafil alleviated a neuronal loss and reduced the infarction volume. And results of behavior task and immunofluorescence shown possibility that anti-inflammation process and improve motor deficits sildenafil treatment after mild ischemic stroke. Furthermore, sildenafil treatment attenuated the alteration of theta-frequency rhythm in the CA1 region of the hippocampus, a known neural oscillatory marker for anxiety disorder in rodents, induced by mild ischemic stroke. Conclusion : PDE5i as effective therapeutic agents for anxiety and movement disorders and provide robust preclinical evidence to support the development and use of PDE5i for the treatment of mild ischemic stroke residual disorders.

A Study on the Complications of Acute Ischemic Cerebrovascular Disease Patients (급성기 허혈성 뇌중풍(중풍)의 합병증에 관한 연구)

  • Hsia, Yu-Chun;Jung, Ki-Yong;Go, Ho-Yeon;Jung, Seung-Min;Jung, Hee;Ko, Mi-Mi;Kang, Mi-Suk;Choi, You-Kyung;Kim, Dong-Woo;Han, Chang-Ho;Cho, Ki-Ho;Park, Jong-Hyung;Ko, Seung-Gyu;Jun, Chan-Yong
    • The Journal of Internal Korean Medicine
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    • 제28권1호
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    • pp.25-33
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    • 2007
  • Background and Purpose : This study was to survey complication according to the TOAST classification and Sasangconstitution in first-ever AICD (acute ischemic cerebrovascular disease) patients. Methods : From 1 Oct. 2005 to 31 Oct. 2006. 97 patients with a first-ever stroke were included in the study. patients were hospitalized within 14 days after the onset of stroke at Kyungwon University Incheon Oriental Hospital. We recorded patient's complications according to the standard operation procedure of 'A stroke study for standardization and science on Korean Medicine' Results : Complications were recorded in 23 cases (24%). The most common complication was upper respiration infection in 11 cases (11%). No statistical significance was shown between complications of AICD and Sasangconstitutions, but complications rate of LAA was higher than SVO in AICD patients (odds ratio 4.17 95% CI 1.127${\sim}$7.307). Conclusions : To acquire more concrete data on this theme. we need further and larger scale research.

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