• Title/Summary/Keyword: brainstem

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Treatment of Brainstem Cavernous Malformation: Treatment Indication, Technical Consideration, and Results

  • Lee, Sang-Bok;Lee, Jung-Il;Kim, Jong-Soo;Hong, Seung-Chyul;Park, Kwan
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.173-178
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    • 2005
  • Objective: The goal of this study is to provide the clinical data of patients with brainstem cavernous hemangiomas after treatment with microsurgery or radiosurgery after conducting a retrospective analysis of 21 patients at one institution. Methods: Twenty one patients with brainstem cavernous hemangiomas were treated at the authors' institution between 1995 and 2004 and clinical analysis was performed by retrospective review of medical records and neuroimaging examinations. Thirteen patients underwent microsurgical resection and radiosurgery was performed as an initial treatment in 9 patients. Results: Radical excision was achieved in 12 among 13 patients and transitory neurological deterioration or new neurological deficit developed during the immediate postoperative period in 7 (54%). The final outcomes at 5 - 70 months after surgery were improved in 11 patients (85%) and worsened in 2 patients (15%) compared with the preoperative state. Radiosurgery was performed in 9 patients. During the follow up period from 5 to 70 months there was neurological improvement in 3 patients, no significant change in 3 and deterioration in 3 patients. Two patients developed rebleeding at 5 months, 60 months respectively after radiosurgery. Conclusion: Microsurgery for symptomatic cavernous hemangioma of brainstem can be performed with acceptable morbidity. Fatal complication is rare with careful selection of the optimal operative approach in well selected patients. Radiosurgery is an effective alternative for the lesions which are not accessible by surgical approach, however, there is still a possibility of rebleeding over a long period after radiosurgical treatment and microsurgery should be considered as a treatment with priority for the majority of cases.

Effect of stimulation-duration of high frequency electroacupuncture on the neuronal activities in the spinal cord and brainstem using Fos immunohistochemical technique (고빈도전침자극(高頻度電鍼刺戟)의 자극시간(刺戟時間)에 따른 중추신경계(中樞神經系) 신경세포(神經細胞)의 활성변화(活性變化)에 미치는 영향(影響))

  • Sohn Sung-Sae;Nam Sang-Soo;Lee Jae-Dong;Choi Do-Young;Ahn Byoung-Choul;Park Dong-Seok;Lee Yun-Ho;Choi Yong-Tae
    • Journal of Acupuncture Research
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    • v.15 no.2
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    • pp.17-28
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    • 1998
  • The present study was designed to investigate the effect of different stimulation-duration of high frequency electroacupuncturet(EA) treatment on the neuronal activities in the spinal cord and brainstem using Fos immunohistochemical technique. Three different stimulus-duration was used in this experiment : 30minutes, 1 hour and 2 hours. The summerized results were summerized as follow : 1. The number of Fos expression was significantly increased in the spinal cord dorsal horn depending upon the increase of stimulus-duration (P<0.05). Otherwise, there was no significant difference between 30 minutes EA treated group and anesthetic control. 2. High frequency EA biphasic stimulation significantly enhanced the Fos expression in the DR, middle and rostral portion of PAG LD, and caudal PAG LV after 1 hour and 2 hours treatment. The number of Fos immunoreactive neuron in the brainstem was increased accorcting to the length of stimulus-duration. Those results indicate that at least 1 hour EA treatment was necessary to increase the neuronal activities in the spinal cord and brainstem. Those basic data from this study can be applied to establish the effective treatment of EA for pain control in the clinical field.

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Unilateral Deafness Diagnosed using the Brainstem Auditory Evoked Response Test in a Shih-tzu Dog

  • Ji, Na-Ni;Song, Joong-Hyun;Hwang, Tae-Sung;Lee, Hee-Chun;Yu, Do-Hyeon;Kang, Byeong-Teck;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.35 no.3
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    • pp.103-106
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    • 2018
  • A 12-year-old castrated male Shih Tzu presented with suspected hearing loss. The patient had no history of head trauma or exposure to ototoxic drugs. The results of neurologic and physical examinations were normal. An otoscopic examination showed that both the tympanic membranes and the external ear canals had a normal appearance. However, the results of brainstem auditory evoked response tests confirmed sensorineural deafness in the right ear and indicated conduction disturbances and brainstem abnormalities in the left ear. Magnetic resonance imaging was performed to confirm the causes of the conduction disturbances and brainstem abnormalities. Inflammatory changes in the left middle ear were highly suspected to be responsible for the findings in the left ear. The results of these examinations confirmed complete hearing loss in the right ear and indicated otitis media in the left ear, which could have been the cause of the conduction disturbances.

Sound-Field Speech Evoked Auditory Brainstem Response in Cochlear-Implant Recipients

  • Jarollahi, Farnoush;Valadbeigi, Ayub;Jalaei, Bahram;Maarefvand, Mohammad;Zarandy, Masoud Motasaddi;Haghani, Hamid;Shirzhiyan, Zahra
    • Korean Journal of Audiology
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    • v.24 no.2
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    • pp.71-78
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    • 2020
  • Background and Objectives: Currently limited information is available on speech stimuli processing at the subcortical level in the recipients of cochlear implant (CI). Speech processing in the brainstem level is measured using speech-auditory brainstem response (S-ABR). The purpose of the present study was to measure the S-ABR components in the sound-field presentation in CI recipients, and compare with normal hearing (NH) children. Subjects and Methods: In this descriptive-analytical study, participants were divided in two groups: patients with CIs; and NH group. The CI group consisted of 20 prelingual hearing impairment children (mean age=8.90±0.79 years), with ipsilateral CIs (right side). The control group consisted of 20 healthy NH children, with comparable age and sex distribution. The S-ABR was evoked by the 40-ms synthesized /da/ syllable stimulus that was indicated in the sound-field presentation. Results: Sound-field S-ABR measured in the CI recipients indicated statistically significant delayed latencies, than in the NH group. In addition, these results demonstrated that the frequency following response peak amplitude was significantly higher in CI recipients, than in the NH counterparts (p<0.05). Finally, the neural phase locking were significantly lower in CI recipients (p<0.05). Conclusions: The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech process in CI recipients.

Sound-Field Speech Evoked Auditory Brainstem Response in Cochlear-Implant Recipients

  • Jarollahi, Farnoush;Valadbeigi, Ayub;Jalaei, Bahram;Maarefvand, Mohammad;Zarandy, Masoud Motasaddi;Haghani, Hamid;Shirzhiyan, Zahra
    • Journal of Audiology & Otology
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    • v.24 no.2
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    • pp.71-78
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    • 2020
  • Background and Objectives: Currently limited information is available on speech stimuli processing at the subcortical level in the recipients of cochlear implant (CI). Speech processing in the brainstem level is measured using speech-auditory brainstem response (S-ABR). The purpose of the present study was to measure the S-ABR components in the sound-field presentation in CI recipients, and compare with normal hearing (NH) children. Subjects and Methods: In this descriptive-analytical study, participants were divided in two groups: patients with CIs; and NH group. The CI group consisted of 20 prelingual hearing impairment children (mean age=8.90±0.79 years), with ipsilateral CIs (right side). The control group consisted of 20 healthy NH children, with comparable age and sex distribution. The S-ABR was evoked by the 40-ms synthesized /da/ syllable stimulus that was indicated in the sound-field presentation. Results: Sound-field S-ABR measured in the CI recipients indicated statistically significant delayed latencies, than in the NH group. In addition, these results demonstrated that the frequency following response peak amplitude was significantly higher in CI recipients, than in the NH counterparts (p<0.05). Finally, the neural phase locking were significantly lower in CI recipients (p<0.05). Conclusions: The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech process in CI recipients.

Bickerstaff's Brainstem Encephalitis with Guillain-Barr$\acute{e}$ Syndrome Presenting Severe Paralytic Ileus (길랑-바레증후군이 동반된 Bickerstaff 뇌줄기뇌염에서 나타난 심한 마비성 장 폐색)

  • Park, Min-Su
    • Annals of Clinical Neurophysiology
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    • v.11 no.1
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    • pp.33-36
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    • 2009
  • Bickerstaff's brainstem encephalitis (BBE) is an autoimmune central nervous system disorder. It can occur in more limited forms and may overlap with Guillain-Barr$\acute{e}$ syndrome (GBS). A 49-year-old female presented with rapidly progressive paralytic ileus, urinary retention, deep drowsiness, ophthalmoplegia, dysarthria, ataxia, quadriparesis and hyporeflexia after viral meningitis. She was diagnosed as BBE with GBS and treated with immunoglobulin. She was completely recovered after 1 month. It is a rare case of BBE overlapping with GBS presenting with severe paralytic ileus.

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Intraoperative Neuromonitoring (수술 중 신경계 감시)

  • Seo, Dae-Won
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.1-12
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    • 2008
  • Intraoperative neuromonitoring (INM) is well known to be useful method to reduce intraoperative complications during the surgery of nervous system lesions. Evoked potentials are most commonly used among the electrophysiological tests. Brainstem auditory evoked potentials are for detecting the problems along the auditory pathways including the eighth cranial nerve and brainstem. Somatosensory evoked potentials are applied for preventing the spinal cord lesions. The INM is affected by many factors. In order to perform an optimal INM, the confounding factors including technical, anesthetical, and individual factors should be kept well under control. INM has frequent electrophysiologic changes during the surgery and it might be helpful to keep one's eyes on which monitoring modalities are reluctant to change during each operation. The skillful monitoring and timely interpretation of electrophysiologic changes can drive the patient to be undergone surgery, even in high surgical risk group.

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Correlation of acoustic features and electrophysiological outcomes of stimuli at the level of auditory brainstem (자극음의 음향적 특성과 청각 뇌간에서의 전기생리학적 반응의 상관성)

  • Chun, Hyungi;Han, Woojae
    • The Journal of the Acoustical Society of Korea
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    • v.35 no.1
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    • pp.63-73
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    • 2016
  • It is widely acknowledged that the human auditory system is organized tonotopically and people generally listen to sounds as a function of frequency distribution through the auditory system. However, it is still unclear how acoustic features of speech sounds are indicated to the human brain in terms of speech perception. Thus, the purpose of this study is to investigate whether two sounds with similar high-frequency characteristics in the acoustic analysis show similar results at the level of auditory brainstem. Thirty three young adults with normal hearing participated in the study. As stimuli, two Korean monosyllables (i.e., /ja/ and /cha/) and four frequencies of toneburst (i.e., 500, 1000, 2000, and 4000 Hz) were used to elicit the auditory brainstem response (ABR). Measures of monosyllable and toneburst were highly replicable and the wave V of waveform was detectable in all subjects. In the results of Pearson correlation analysis, the /ja/ syllable had a high correlation with 4000 Hz of toneburst which means that its acoustic characteristics (i.e., 3671~5384 Hz) showed the same results in the brainstem. However, the /cha/ syllable had a high correlation with 1000 and 2000 Hz of toneburst although it has acoustical distribution of 3362~5412 Hz. We concluded that there was disagreement between acoustic features and physiology outcomes at the auditory brainstem level. This finding suggests that an acoustical-perceptual mapping study is needed to scrutinize human speech perception.

Effect of N-methyl-D-aspartic acid(NMDA)-and Non NMDA-Receptor Agonists on Serotonin Release from Cultured Neurons of Fetal Rat Brainstem (뇌간 신경세포 배양에서 세로토닌 분비에 대한 N-methyl-D-aspartic Acid(NMDA) 및 Non-NMDA 수용체 효현제들의 작용)

  • Yoo, Soon-Mi;Kim, Yul-A;Song, Dong-Keun;Suh, Hong-Won;Kim, Yung-Hi
    • The Korean Journal of Pharmacology
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    • v.31 no.2
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    • pp.141-144
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    • 1995
  • Serotonergic neurons in brainstem play important roles in the endogenous descending pain inhibitory system. To illucidate the involvement of glutamate receptors in the regulation of brainstem serotonergic neurons, we studied the effects of glutamate receptor agonists on 5-hydroxytryptamine(5-HT) release from cultured neurons of rat fetal (gestational age 14th day) brainstem. Cultured cells maintained for 10 days in vitro were stimulated for 30 minutes with agonists of glutamate receptor subtypes at 10-1,000 micromolar concentration. Glutamate (10-1,000 M) increased 5-HT release in a concentration-dependent manner. N-methyl-D-aspartic acid $(NMDA)(10-1,000\;{\mu}M)$ increased 5-HT release in a concentration-dependent manner. Non-NMDA receptor agonists, kainate and $AMPA(3-1,000\;{\mu}M)$ also concentration-dependently increased 5-HT release. These results suggest that both NMDA and non-NMDA receptors regulate 5-HT release from brainstem serotonergic neurons.

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Hearing Test in Infant and Young Children Using MASTER (Multiple Auditory Steady-State Response(MASTER)을 이용한 유소아의 청력검사)

  • Lee, Hak-Sun;Kim, Shi-Chan
    • Speech Sciences
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    • v.11 no.4
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    • pp.143-150
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    • 2004
  • This study was done to compare thresholds between those of Auditory Brainstem Response (ABR) with clicks or tonebursts and Multiple Auditory Steady-State Response (MASTER). The results would give a promising tool for evaluating frequency-specific hearing sensitivity in infants or young children. The correlation coefficient value between the click ABR thresholds and MASTER thresholds at carrier frequencies, 500, 1,000, 2,000 Hz, and 4,000 Hz was obtained at Pearson 0.91, 0.94, 0.93, and 0.91.

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