• Title/Summary/Keyword: brain infarction

Search Result 359, Processing Time 0.027 seconds

Efficacy of the Decompressive Craniectomy for Acute Cerebral Infarction : Timing of Surgical Intervention and Clinical Prognostic Factors

  • Cho, Tae-Koo;Cheong, Jin-Hwan;Kim, Jae-Hoon;Bak, Koang-Hum;Kim, Choong-Hyun;Kim, Jae-Min
    • Journal of Korean Neurosurgical Society
    • /
    • v.40 no.1
    • /
    • pp.11-15
    • /
    • 2006
  • Objective : Acute cerebral infarction is often accompanied by transtentorial herniation which can be fatal. The aim of this study is to determine the timing of surgical intervention and prognostic factors in patients who present with acute cerebral infarction. Methods : We reviewed retrospectively 23 patients with acute cerebral infarction, who received decompressive craniectomy or conservative treatment from January 2002 to December 2004. We divided patients into two groups according to the treatment modalities [Group 1 : conservative treatment, Group 2 : decompressive craniectomy]. In all patients, the outcome was quantified with Glasgow Outcome Scale and Barthel Index. Results : Of the 23 patients, 11 underwent decompressive craniectomy. With decompressive craniectomy at the time of loss of pupillary light reflex, we were able to prevent death secondary to severe brain edema in all cases. Preoperative Glasgow Coma Scale and loss of pupillary light reflex were significant to the clinical outcome statistically. With conservative treatment, 9 of the 12 patients died secondary to transtentorial herniation. The clinical outcomes of remaining 3 patients were poor. Conclusion : This study confirms the value of life-saving procedure of decompressive craniectomy after acute cerebral infarction. We propose that the loss of pupillary light reflex should be considered one of the most important factors to determine the timing of the decompressive craniectomy.

Case Study of Cerebellar Infarction Base on Oriental Medical Diagnosis of Dongeuibogam (동의보감 현훈, 운동실조의 내용을 중심으로 살펴본 소뇌경색 환자 치료경과 3례)

  • Lee, Jae-Wang;Hong, Sang-Hoon;Kim, Jung-Eun;Son, Ho-Young;Kim, Do-Gyoung;Sin, Cheol-Kyung
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.23 no.6
    • /
    • pp.1497-1502
    • /
    • 2009
  • The cerebellum processes input from other areas of the brain, spinal cord and sensory receptors to provide precise timing for coordinated, smooth movements of the skeletal muscular system. A stroke affecting the cerebellum may cause vertigo, nausea, balance and coordination problems. The papers on central vertigo caused by cerebellar infarction were reported by Kim, Ku, Ko, Choi, and Han. Their cases were classed as Heo hoon, Dam hoon, and Sangchopungyeul yeul dam, and they treated with Jaeumkunbi-tang, Taeksa-tang, Cheonghunwhadam-tang gami, Cheonginwhadam-tang, Hachulbosim-tang. In this paper, three patients who suffered from vertigo were diagnosed as cerebellar infarction. They felt too giddy to walk without any help. After Oriental medical treatment based on Dongeuibogam, their sequelae of cerebellar infarction - vertigo, nausea, ataxia - had improved dramatically. So we report these cases, and suggest Oriental medical treatment based on Dongeuibogam have effect on cerebellar infarction. But more clinical case reports should be further examined.

Impact of Cardio-Pulmonary and Intraoperative Factors on Occurrence of Cerebral Infarction After Early Surgical Repair of the Ruptured Cerebral Aneurysms

  • Chong, Jong-Yun;Kim, Dong-Won;Jwa, Cheol-Su;Yi, Hyeong-Joong;Ko, Yong;Kim, Kwang-Myung
    • Journal of Korean Neurosurgical Society
    • /
    • v.43 no.2
    • /
    • pp.90-96
    • /
    • 2008
  • Objective: Delayed ischemic deficit or cerebral infarction is the leading cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study is to reassess the prognostic impact of intraoperative elements, including factors related to surgery and anesthesia, on the development of cerebral infarction in patients with ruptured cerebral aneurysms. Methods: Variables related to surgery and anesthesia as well as predetermined factors were all evaluated via a retrospective study on 398 consecutive patients who underwent early microsurgery for ruptured cerebral aneurysms in the last 7 years. Patients were dichotomized as following; good clinical grade (Hunt-Hess grade I to III) and poor clinical grade (IV and V). The end-point events were cerebral infarctions and the clinical outcomes were measured at postoperative 6 months. Results: The occurrence of cerebral infarction was eminent when there was an intraoperative rupture, prolonged temporary clipping and retraction time, intraoperative hypotension, or decreased $O_2$ saturation, but there was no statistical significance between the two different clinical groups. Besides the Fisher Grade, multiple logistic regression analyses showed that temporary clipping time, hypotension, and low $O_2$ saturation had odds ratios of 1.574, 3.016, and 1.528, respectively. Cerebral infarction and outcome had a meaningful correlation (${\gamma}$=0.147, p=0.038). Conclusion: This study results indicate that early surgery for poor grade SAH patients carries a significant risk of ongoing ischemic complication due to the brain's vulnerability or accompanying cardio-pulmonary dysfunction. Thus, these patients should be approached very cautiously to overcome any anticipated intraoperative threat by concerted efforts with neuro-anesthesiologist in point to point manner.

Analysis of Treatment Effect According to the Period of Herbal Treatment in Cerebral Infarction Patients Admitted with Hemiplegia: Retrospective Medical Chart Review (편마비를 주소증으로 입원한 뇌경색 환자의 한방 치료 시기에 따른 치료 효과 분석 : 후향적 의무기록 분석)

  • Choi, Yu-jin;Kim, Ki-tae;Shin, Seon-mi;Ko, Heung
    • The Journal of Internal Korean Medicine
    • /
    • v.40 no.4
    • /
    • pp.675-696
    • /
    • 2019
  • Objective: This study was aimed at evaluating the effect and clarifying the treatment period of Korean medicine treatment for cerebral infarction. Method: This study was carried out on patients with hemiplegia who were hospitalized in the Department of Korean Internal Medicine of Jecheon Korean Medicine Hospital of Semyung University from June 2014 to May 2019. A retrospective study was performed on 253 patients who were diagnosed with cerebral infarction by brain CT or nuclear magnetic resonance imaging. Results and Conclusion: 1. Korean medicine treatment has a significant effect on improving the movement disorder and daily life independence of cerebral infarction. 2. In the group that started Korean medical treatment within one month after the onset of cerebral infarction, with the exception of MMSE-K, the indicators related to the movement disorder and daily life independence showed significant effect. 3. MMSE-K showed no statistically significant change in any of the patient groups. 4. Within three months after the onset date, the longer the period of treatment with Korean medicine, the better the symptom improvement of upper extremity movement disorder. 5. The longer the hospital stays, the better the symptom improvement of the lower extremity movement disorder. 6. The combination of Korean and Western medicine did not affect liver or kidney function.

The Effects of Hibiscus Syriacus Extract on the Alzheimer's Disease Mice Model Induced by $\betaA$ (목근피가 $\betaA$로 유도된 Alzheimer's Disease 생쥐 모델에 미치는 영향)

  • Lee Sang Ryong;Jung In Chul
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.18 no.3
    • /
    • pp.797-807
    • /
    • 2004
  • This research investigates the effect of the Hibiscus syriacus(HSS) on Alzheimer's disease. The effects of the HSS extract on the behavior in the Morris water maze experiment; the expression of IL-1β, TNF-α, IL-1β mRNA, TNF-α mRNA, CD68/GFAP and RDS; the the infarction area of the hippocampus, and brain tissue injury in Alzheimer's diseased mice induced with M were investigated. The HSS extract group showed a significant inhibitory effect on the memory deficit on the mice with Alzheimer's disease induced by βA in the Morris water maze experiment. The HSS extract group suppressed the over-expression of IL-1β, TNF-α, IL-1β and TNF-α mRNA, CD68/GFAP, RDS in the mice with Alzheimer's disease induced by βA. The HSS extract reduced the infarction area of hippocampus, and controlled the injury of brain tissue in the mice with Alzheimer's disease induced by βA. This study suggest that HSS may be effective for the prevention and treatment of Alzheimer's disease

The Effect of Modified Boyanghwano-tang on the Brain Infarction Through the Anti-apoptosis of Neuronal Cells in Ischemic Rats (가미보양환오탕이 뇌허혈모델에서 신경세포보호를 통해 뇌경색억제에 미치는 효과)

  • Han, Chang-Ho;Park, Yong-Ki
    • Journal of Acupuncture Research
    • /
    • v.27 no.4
    • /
    • pp.29-38
    • /
    • 2010
  • Objectives : The purpose of the study is to determine the neuroprotective effect of modified Boyanghwano-tang(mBHT), a traditional Korean medicine, on the transient focal cerebral ischemia in rats. Methods : Focal ischemia and reperfusion were induced by middle cerebral artery occlusion(MCAO) for 90 min, followed by 144 h reperfusion in rats. mBHT(200mg/kg body weight, p.o.) was administrated in rats once a day during reperfusion. At the end of treatment, brain infarction was measured by TTC staining, and histological change was observed by H&E staining. The expressions of Bax, Bcl-2 and cytochrome c in ischemic brains were determined by immunofluorescent analysis. Results : mBHT significantly reduced the cerebral infarct volumes of the MCAO rats. mBHT also attenuated the neuronal cell death and the expressions of pro-apoptotic molecules, bax and cytochrome c in ischemic brains. Further, mBHT significantly increased the survival time of ischemeic rats and the expression of anti-apoptotic molecule, Bcl-2 in ischemic brains. Conclusions : Our results suggest that mBHT is neuroprotective and may prove to be useful adjunct in the treatment of ischemic stroke.

Isolated Weakness of Radial-side Fingers Due to a Small Cortical Infarction (국소 뇌경색에 의한 요골측 손가락 마비)

  • Hwang, Kyoung Jin;Park, Key-Chung;Chang, Dae-Il;Yoon, Sung Sang
    • Investigative Magnetic Resonance Imaging
    • /
    • v.18 no.4
    • /
    • pp.362-365
    • /
    • 2014
  • Predominant involvement of a particular group of fingers due to a central nervous system lesion has been described as pseudoperipheral palsy. Two patients visited our hospital with isolated weakness of a particular group of fingers due to small cortical infarctions. A 51-year-old woman suddenly developed weakness in her left index and middle fingers. The brain MRI showed a small infarct in the right frontal cortex. A 67-year-old man was sudden difficulty using his chopsticks and had weakness in his right thumb and index finger. The brain MRI showed a small infarct in the left precentral cortex.

Polyamines and Their Metabolites as Diagnostic Markers of Human Diseases

  • Park, Myung Hee;Igarashi, Kazuei
    • Biomolecules & Therapeutics
    • /
    • v.21 no.1
    • /
    • pp.1-9
    • /
    • 2013
  • Polyamines, putrescine, spermidine and spermine, are ubiquitous in living cells and are essential for eukaryotic cell growth. These polycations interact with negatively charged molecules such as DNA, RNA, acidic proteins and phospholipids and modulate various cellular functions including macromolecular synthesis. Dysregulation of the polyamine pathway leads to pathological conditions including cancer, inflammation, stroke, renal failure and diabetes. Increase in polyamines and polyamine synthesis enzymes is often associated with tumor growth, and urinary and plasma contents of polyamines and their metabolites have been investigated as diagnostic markers for cancers. Of these, diacetylated derivatives of spermidine and spermine are elevated in the urine of cancer patients and present potential markers for early detection. Enhanced catabolism of cellular polyamines by polyamine oxidases (PAO), spermine oxidase (SMO) or acetylpolyamine oxidase (AcPAO), increases cellular oxidative stress and generates hydrogen peroxide and a reactive toxic metabolite, acrolein, which covalently incorporates into lysine residues of cellular proteins. Levels of protein-conjuagated acrolein (PC-Acro) and polyamine oxidizing enzymes were increased in the locus of brain infarction and in plasma in a mouse model of stroke and also in the plasma of stroke patients. When the combined measurements of PC-Acro, interleukin 6 (IL-6), and C-reactive protein (CRP) were evaluated, even silent brain infarction (SBI) was detected with high sensitivity and specificity. Considering that there are no reliable biochemical markers for early stage of stroke, PC-Acro and PAOs present promising markers. Thus the polyamine metabolites in plasma or urine provide useful tools in early diagnosis of cancer and stroke.

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
    • /
    • v.26 no.7
    • /
    • pp.526-531
    • /
    • 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.

  • PDF