• Journal of Pharmacopuncture
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• v.14 no.3
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• pp.5-17
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• 2011

Objectives : Gliosis becomes physical and mechanical barrier to axonal regeneration. Reactive gliosis induced by middle cerebral artery occlusion is involved with up-regulation of CD81 and GFAP (Glial fibrillary acidic protein). The current study is to examine the effect of the Angelica gigas Nakai(intravenous injection. 100 mg/kg twice in a day) on CD81 and GFAP of the rat in the brain after middle cerebral artery occlusion. Methods : Cerebral infarction was induced by middle cerebral artery occlusion. And after intravenous injection of water extract of Angelica gigas Nakai, the size of cerebral infarction was measured. Examination of optical microscope were also used to detect the expression of CD81 and GFAP in the brain of the rat. Results : The following results were obtained : We found that size of cerebral infarcion induced by MCAO (Middle Cerebral Artery Occlusion) in rats were decreased after intravenous injection of Angelica gigas Nakai. We injected the extract of Angelica gigas Nakai to the MCAO in rats, and the optical microscope study showed that Angelica gigas Nakai had effect on protecting the cells of hippocampus. We found that GFAP, CD81 and ERK of the brain in rats with cerebral infarction after MCAO were meaningfully decreased after intravenous injecting Angelica gigas Nakai. We found that c-Fos expression of the brain in rats with cerebral infarction after MCAO were significantly increased after intravenous injecting Angelica gigas Nakai. Conclusions : These results indicate that Angelica gigas Nakai could suppress the reactive gliosis, which disturbs the astrocyte regeneration in the brain of the rat with cerebral infarction after MCAO by controlling the expression of CD81 and GFAP. And the effect may be modulated by the up-regulation of c-Fos and ERK.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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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 radiological science and technology
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• v.42 no.5
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• pp.351-356
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• 2019

This study aimed to determine whether there was a difference in measurements between North American Symptomatic Carotid Endarterectomy Trial(NASCET) and Warfarin-Aspirin Symptomatic Intracranial Disease(WASID) methods that measure the middle cerebral artery stenosis in Digital Subtraction Angiography (DSA) and Magnetic Resonance Angiography (MRA). It involved 24 patients who had completed both DSA and MRA among patients with Middle Cerebral Artery (MCA) stenosis. The Middle Cerebral Artery (MCA) stenosis was measured using the NASCET and WASID methods through a retrospective analysis. For the NASCET and WASID methods, they performed measurements on normal blood vessels located far from and close to the stenosis, respectively. The mean value and standard deviation of the Digital Subtraction Angiography (DSA) measured by the NASCET method were 59.23% and 13.27%. On the other hand, those of the Digital Subtraction Angiography (DSA) measured by the WASID method were 66.64% and 12.47%. And, the mean value and standard deviation of the Magnetic Resonance Angiography (MRA) measured by the NASCET method were 49.82% and 12.06%. By contrast, those of the Magnetic Resonance Angiography (MRA) measured by the WASID method were 56.63% and 10.67%. All the p-values obtained by the Pearson and Spearman correlation tests in the Digital Subtraction Angiography (DSA) and the Magnetic Resonance Angiography (MRA) were <0.01. In conclusion, this study suggests that both the NASCET and WASID methods to measure the middle cerebral artery stenosis in the Digital Subtraction Angiography (DSA) and the Magnetic Resonance Angiography (MRA) can be used if they are not used interchangeably.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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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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• v.38 no.6
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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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• v.37 no.4
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• pp.263-267
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• 2005

Objective: Middle cerebral artery(MCA) anomalies are found incidentally on conventional cerebral angiography and magnetic resonance angiography(MRA). Our goal is to examine the incidence and types of MCA anomalies. Methods: Cerebral angiography was performed in 448 patients and MRA in 743; the patients had or were suspected to have cerebrovascular disease. The images were retrospectively evaluated for arterial anatomic anomalies. We use Teal's classification for definition of accessory and duplicated MCAs. Results: On cerebral angiography, the following anomalies of the MCA were found in seven patients: fenestration (n = 2, incidence = 0.45%); duplication (n = 2, incidence = 0.45%); accessory MCA (n = 2, incidence = 0.45%); aplasia (n = 1, incidence = 0.22%). On MRA, eight patients had anomalous MCAs : fenestration (n = 1, incidence = 0.14%); duplication (n= 6, incidence = 0.81%); accessory (n = 1, incidence = 0.14%). Conclusion: Although the clinical significance is not great, we find a relatively high incidence of anomalous MCAs. Knowledge and recognition of these MCA anomalies are useful and important in the interpretation of cerebral images and during neurosurgical procedures.

• The Journal of Korean Medicine
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• v.25 no.1
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• pp.117-128
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• 2004

Objectives : This research was performed to investigate effect of Samul-tang-gamibang against focal cerebral ischemic damage after middle cerebral artery occlusion(MCAO). Methods : This research was used rats which were against focal cerebral ischemic damage by MCAO. It was used Zea Longa's theory and Belayev's methods to give rise to focal cerebral ischemic damage by MCAO. After 7days later, we drew out the brain and then had frozen and dyeing it and we had taken a picture to measure of the damaged area in each brain section. We determined the Neurological Index and tested the Foot-fault test and Roatated test to appraise the fall of motion ability result from cerebral ischemic damage. Results : The results of the experiment are as follows. 1. Samul-tang-gamibang reduced infarct size of sample group compared to control group at 7 day after MCAO. 2. Samul-tang-gamibang reduced infarct volume of sample group compared to control group at 7 day after MCAO. 3. Samul-tang-gamibang reduced foot-fault index of sample group compared to control group at 5,7 day after MCAO. Conclusions : Samul-tang-gamibang has protective effects against ischemic brain damage and had significant reduced infarct size and infarct volume of Rt-MCAO.

• The Journal of Korean Medicine
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• v.30 no.2
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• pp.117-126
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• 2009

Objectives: This study was performed to investigate the effects of Semen Persicae (SP) on infarct volume, COX-2 protein expression in the middle cerebral artery occlusion (MCAo) rats. Methods: Twenty-eight rats were randomly assigned to four groups (MCAo experimental group, MCAo control group, sham experimental group, control group). The middle cerebral artery (MCA) was occluded in the MCAo group by proximal focal cerebral ischemia rat model, while the MCA was not occluded in the sham group. SP extraction was administrated for 4 days to each experimental group. Neuroprotective effects were investigated by measurement of brain damage using 2, 3, 5-triphenyltetrazolium chloride staining and analysis of COX-2 protein expression by western blotting. Results: The occurrence of infarct volume in the SP oral administration group decreased compared to the control group. COX-2 protein expression in the SP oral administration group decreased compared to the control group. Conclusions: The present study demonstrates the effect of SP in reducing infarct volume and decreasing COX-2 expression.

• Journal of Korean Neurosurgical Society
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• v.52 no.5
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• pp.501-504
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• 2012

Objective : To report our surgical experience using in situ end-to-side bypass for giant serpentine distal anterior cerebral artery aneurysm, unsuitable for microsurgical clipping. Methods : A 49-year-old woman presented with headache and intermittent loss of consciousness. The brain computed tomography scan revealed a partially calcified mass in the interhemispheric fissure. On cerebral angiography, that was giant ($30{\times}18mm$ sized), serpentine aneurysm originating from the A2 to A3 segment of the distal anterior cerebral artery (DACA). The aneurysm was trapped with clips, and the right A3 segment to left A3 segment of DACA, end-to-side in situ bypass was performed. Surgical result was favorable, with no newly developed ischemic event in the acute recovery period. Postoperative angiography showed total occlusion of the aneurysm and good patency, with preserved distal flow. Conclusion : Giant fusiform aneurysms of the DACA are extremely rare and can be particularly challenging to treat. End-to-side A3 : A3 bypass with aneurysm trapping could be a treatment modality for these locations.

• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.289-292
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• 2009

Objective : Although there are several descriptions of this vessel, there is no detailed angiographic study of the accessory middle cerebral artery (AMCA) in Korea. We describe the angiographic characteristics of the cortical territory and origin of AMCA and discuss the clinical significance of this anomaly. Methods : We searched for patients with AMCAs from a retrospective review of 1,250 conventional cerebral angiograms. We determined the origins, diameters and cortical territories of these AMCAs. Results : Fifteen patients (15 of 1250 = 1.2%) had 16 AMCAs (one patient had bilateral AMCAs). AMCAs originated from the distal A1 in eleven cases, middle A1 in two, proximal A1 in two, and proximal A2 in one case. All AMCAs followed a course parallel to the main middle cerebral artery (MCA). All but three of these arteries were smaller than the main MCA. Thirteen of the smaller diameter AMCAs had cortical distribution to the orbito-frontal and prefrontal, and precentral areas. Three AMCAs had diameter as large as the main MCA. These three supplied the orbito-frontal, prefrontal, precentral, central and anterior-parietal arteries. Conclusion : The AMCAs originated from A1 or A2. Most had smaller diameter than the main MCA. The AMCAs coursed along the horizontal portion of the MCA, but supplied the orbital surface, the anterior frontal lobe and sometimes wider cortical territory, including the precentral, central, anterior-parietal areas.