• 동의생리병리학회지
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• 제30권1호
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• pp.73-79
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• 2016

It was aimed to report a case of both anterior cerebral artery territory infarction patient improved by korean medical treatment. The patient was diagnosed by brain magnetic resonance imaging(MRI) and magnetic resonance angiography(MRA). The symptoms were quadriplegia, urinary frequency, urinary incontinence and abulia. I applied herbal medicine, acupuncture, moxibustion, pharmacopuncture, cupping and physical exercise therapy. As a result of them, the symptoms of the patient were improved considerably. Status of the patient was evaluated by manaul muscle test(MMT), modified barthel index(MBI) and functional independence measure(FIM) and medical interview. MBI score was changed from 35 to 95 and FIM score was changed from 66 to 115. Therefore this report suggests that korean medical treatment could be effective to the anterior cerebral artery territory infarction.

• 대한한방내과학회지
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• 제37권2호
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• pp.330-336
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• 2016

Objectives: This clinical study was conducted to evaluate the effectiveness of traditional Korean medicine (TKM) on a patient with akinetic mutism.Method: A patient with akinetic mutism diagnosed with left-anterior cerebral artery infarction was treated with acupuncture and herbal medication; the patient was then evaluated for any improvements in clinical symptoms.Results: Improvements in akinetic mutism symptoms were observed following the TKM treatment.Conclusion: This study shows that TKM treatment for akinetic mutism due to left-anterior cerebral artery infarction may be an effective treatment option.

• Journal of Korean Neurosurgical Society
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• 제53권2호
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• pp.115-117
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• 2013

Simultaneous subarachnoid hemorrhage and infarction is a quite rare presentation in a patient with a spontaneous dissecting aneurysm of the anterior cerebral artery. Identifying relevant radiographic features and serial angiographic surveillance as well as mode of clinical manifestation, either hemorrhage or infarction, could sufficiently determine appropriate treatment. Enlargement of ruptured aneurysm and progressing arterial stenosis around the aneurysm indicates impending risk of subsequent stroke. In this setting, prompt treatment with stent-assisted endovascular embolization can be a reliable alternative to direct surgery. When multiple arterial dissections are coexistent, management strategy often became complicated. However, satisfactory clinical results can be obtained by acknowledging responsible arterial site with careful radiographic inspection and antiplatelet medication.

• Journal of Korean Neurosurgical Society
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• 제38권6호
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• pp.465-467
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• 2005

Anterior cerebral artery[ACA] dissecting aneurysms are extremely rare and optimal treatment remains unclear. The majority of cases manifest as cerebral infarction or as intracranial bleeding. The authors report two cases of ACA dissecting aneurysm, one with a large partially thrombosed gradually growing aneurysm and one with a cerebral infarction in the ACA territory. The patient with a large aneurysm was treated by trapping the aneurysm, and the patient with infarction by conservative management. We report on two cases of dissecting aneurysm of the ACA and include a review of pertinent literature.

• Journal of Korean Neurosurgical Society
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• 제38권5호
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• pp.393-395
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• 2005

Cerebral infarction rarely occur following head injury. The authors present the case of a 39-year-old man with complete infarction in the middle cerebral artery[MCA] and anterior cerebral artery[ACA] territories ccurred immediately after head injury. He had compound depressed fracture in right frontal bone with no neurological deficit. After the depressed bone elevation, postoperative computed tomography scan showed the right MCA and ACA territory infarction with midline shift. Cerebral angiography obtained on the day after emergent decompressive craneictomy showed the complete occlusion of the internal carotid artery[ICA] at the level of lacerum ICA segment. There was no evidence of neck vessel dissection and basal skull fracture. Cerebral infarction can occur in an ultraearly period after head injury without neck vessel dissection or basal skull fracture. We stress the need for attention to the cerebral infarction as the cause of a rare neurological deterioration of the head trauma.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.832-835
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• 2000

A case of unruptured cerebral aneurysm at the junction of accessory middle cerebral artery and the distal portion of the $A_1$ segment of the anterior cerebral artery is reported. To the authors' knowledge, this is the first reported case of cerebral aneurysm developed at the junction of accessory middle cerebral artery, demonstrated on magnetic resonance angiography(MRA). The accessory middle cerebral artery is a rare vascular variant of middle cerebral artery. Furthermore, it is extremely rare for an aneurysm to be developed at the origin of the accessory middle cerebral artery. The development of the accessory middle cerebral artery is very important in surgery of cerebral aneurysm and collateral circulation of cerebral infarction. Review of the literature regarding the genesis and anatomical variation of the accessory middle cerebral artery is also presented.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.400-404
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• 2016

We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA. Because the volume of infarction in the territory of the right MCA was extensive, we judged the use of intravenous tissue plasminogen activator to be contraindicated. Cerebral angiography revealed hypoplasia of both vertebral arteries and the presence of a PPTA from the right internal carotid artery. A microcatheter was introduced into the BA via the PPTA and revascularization was successfully performed using a Merci Retriever with adjuvant low-dose intraarterial urokinase. After treatment, his consciousness level and right motor weakness improved. Although persistent carotid-vertebrobasilar anastomoses such as a PPTA are relatively rare vascular anomalies, if the persistent primitive artery is present, it can be an access route for mechanical thrombectomy for acute ischemic stroke.

• Journal of Korean Neurosurgical Society
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• 제40권3호
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• pp.189-192
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• 2006

Spontaneous dissection of the anterior cerebral artery is an unusual cause of subarachnoid hemorrhage. We present a case of a dissecting aneurysm of the anterior cerebral artery presenting with subarachnoid hemorrhage. A 51-year-old woman presented to our hospital with severe headache. Neurological examination demonstrated neck stiffness, decreased visual acuity of the left eye, and left ankle weakness. Computed tomographic scans showed subarachnoid hemorrhage. The initial cerebral angiogram demonstrated a slightly narrowed caliber and mild poststenotic dilation of the right A1 segment. A second cerebral angiogram 14 days later revealed no change in the focal narrowing of the proximal A1 segment but marked progression of the dilatation of the distal A1 segment. Right pterional craniotomy was performed. A sausage-like dilation of the right A1 segment was found with no definite mural hematoma. This abnormal right A1 segment was wrapped with a Sundt clip. A postoperative computed tomographic scan revealed Infarction of the right head of the caudate nucleus and the anterior limb of the right internal capsule. If a dissecting aneurysm is suspected, serial angiographic studies should be performed because of the possibility of dynamic changes over a short period.

• 대한한방내과학회지
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• 제37권5호
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• pp.786-795
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• 2016

Objective: To evaluate the effectiveness of traditional Korean medicine treatment (TKM) on a patient with ACA infarction and hemorrhagic transformation with hemiplegia and urinary disturbance. Methods: A patient diagnosed with left anterior cerebral artery (ACA) infarction and hemorrhagic transformation was treated with electroacupuncture, moxibustion, and herbal medicine. Results: Improvements in the Manual Muscle Test (MMT), modified Barthel Index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), and K-MMSE were observed following the TKM treatment [MMT Gr. (3/0)→Gr. (4+/4+), MBI 20→89, NIHSS 8→2, mRS 5→1, MMSE-K 21→28]. Conclusion: TKM treatment could help improve the symptoms of patients with ACA infarction and hemorrhagic transformation.

• 한국콘텐츠학회논문지
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• 제19권7호
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• pp.186-191
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• 2019

서론: 최근 노년층에서 뇌졸중 발병률이 증가하고 있다. 현재 뇌졸중 치료제 및 방법이 많이 개발되어 있으나 치료 후에도 후유증 등이 많이 남게 된다. 그래서 아직도 많은 과학자나 임상 의사들이 이를 치료하기 위한 약물 및 방법을 연구하고 있는 실정이다. 많은 연구 중 뇌졸중 치료 연구를 위한 표준화된 실험 동물연구는 드물며, 표준화된 Nylon thread를 이용한 중대뇌동맥 폐쇄모델(MCAO, middle cerebral artery occlusion)의 성공률에 대한 연구는 거의 없다 방법: 본연구는 $0.18{\pm}0.02mm$의 지름을 가진 5-0 Nylon thread를 중대뇌동맥에 삽입하였다. 60분 동안 삽입한 후에 봉합해 놓았던 부위를 다시 절개하여 Nylon thread를 빼내고, 막았던 혈관의 매듭을 풀어주어, 다시 혈액이 공급되게 하였다. 그로부터 23시간 후에 뇌를 내어 1mm 두께로 자른 후 1.5% TTC(2',3',5'-triphenyl-tetrazolium chloride)로 15분간 염색하고, 4% PFA(paraformaldehyde)로 15분 동안 고정하였다. 결과: Nylon thread를 삽입하여, MCA occlusion 50마리, ICA occlusion 14마리, 제대로 된 MCAO model보다 좀 더 깊게 들어간 distal MCAO model 36마리, 너무 깊은 MCA나 ACA까지 들어가서 상보적인 괴사를 나타내는 occlusion model 1마리, 그리고 경색이 일어나지 않은 마우스 50마리를 확인하였다. 결론: 이에 본 연구에서는 Nylon Thread를 생쥐의 무게에 따라 32~36g 인 생쥐는 9mm로 삽입하여주고, 37~40g인 생쥐는 9mm+0.5mm의 깊이로 삽입하여서 1hr의 occlusion과 23hr의 reperfusion을 주어 생쥐를 TTC 염색을 통하여 괴사가 일어난 부분을 확인하였고, 생쥐에서 가역적인 뇌혈관 경색으로 151말중 101마리에서 뇌경색을 유도 할 수 있었다(66.9%).