• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.152-156
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• 2014

We report on a patient who showed visual recovery following bilateral occipital lobe infarct, as evaluated by follow up functional magnetic resonance imaging (fMRI) and diffusion tensor tractography (DTT). A 56-year-old female patient exhibited severe visual impairment since onset of the cerebral infarct in the bilateral occipital lobes. The patient complained that she could not see anything, although the central part of the visual field remained dimly at 1 week after onset. However, her visual function has shown improvement with time. As a result, at 5 weeks after onset, she notified that her visual field and visual acuity had improved. fMRI and DTT were acquired at 1 week and 4 weeks after onset, using a 1.5-T Philips Gyroscan Intera. The fiber number of left optic radiation (OR) increased from 257 (1-week) to 353 (4-week), although the fiber numbers for right OR were similar. No activation in the occipital lobe was observed on 1-week fMRI. By contrast, activation of the visual cortex, including the bilateral primary visual cortex, was observed on 4-week fMRI. We demonstrated visual recovery in this patient in terms of the changes observed on DTT and fMRI. It appears that the recovery of the left OR was attributed more to resolution of local factors, such as peri-infarct edema, than brain plasticity.

• The Journal of Dong Guk Oriental Medicine
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• v.11
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• pp.58-65
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• 2008

Objectives : BHT has been commonly used to treatment of brain disorders in Oriental clinic in Korea. The purpose of this study was to determine the inhibitory effect of modified BHT-C extract on the transient forcal cerebral ischemia in rats. Method : We prepared ischemic rats by the transient middle cerebral artery occlution(MCAO; 90 min occlusion and 144 h reperfusion) in rat brains. BHT-C extract (100 and 200 mg/kg, i.p.) was administered every day after the onset of MCAO until 6 day. Result : BHT-C extract increased survival rate of ischemic rats compared with vehicle-treated rats. BHT-C extract treated rats (100 and 200 mg/kg) were shown a significant reduction in infarct volume compared with vehicle-treated rats. Conclusions : These results suggest that BHT-C extract may contribute to its protective effects in brain ischemia through the reduction of brain infarction.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.388-391
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• 2011

A lesion that is hyperintense on diffusion-weighted imaging (DWI) and hypointense on the apparent diffusion coefficient (ADC) map is a characteristic magnetic resonance imaging (MRI) finding in acute ischemic infarction. In some cases, however, these findings can persist for a few months after infarct onset. It is thought that these finding reflect the different evolution speeds of the infarcted tissue. We report a patient with a right middle cerebral artery territory infarction with persistent hyperintensity on DWI and hypointensity on the ADC map for over 8 months. To our knowledge, this is the most persistent case of hyperintensity lesion on DWI and the serial MRI images of this patient provide important information on the evolution of infarcted tissue.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.2
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• pp.210-215
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• 2024

Cerebral ischemic complications after pituitary surgery are not frequently reported. Multiple mechanisms have been proposed, including vasospasm, and delayed cerebral ischemia resulting from postoperative subarachnoid bleeding. Given the unknown etiology of vasospasm following these situations, little is known about its prevention. Through a case report and bibliographic review, the authors warn about the importance of recognizing key signs postoperatively that could indicate increased risk for cerebral vasospasm and must be recognized in a timely manner, with appropriate treatment strategies implemented once these symptoms present.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.83-91
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• 2007

Background: Cerebral blood vessels are innervated by sympathetic nerves that originate in the superior cervical ganglia (SCG). This study was conducted to determine the effect of an SCG block on brain injury caused by focal cerebral ischemia/reperfusion in a rat model. Methods: Male Sprague-Dawley rats (270-320 g) were randomly assigned to one of three groups (lidocaine, ropivacaine, and control). After brain injury induced by middle cerebral artery (MCA) occlusion/reperfusion, the animals were administered an SCG bloc that consisted of $30{\mu}l$ of 2% lidocaine or 0.75% ropivacaine, with the exception of animals in the control group, which received no treatment. Twenty four hours after brain injury was induced, neurologic scores were assessed and brain samples were collected. The infarct and edema ratios were measured, and DNA fragmented cells were counted in the frontoparietal cortex and the caudoputamen. Results: No significant differences in neurologic scores or edema ratios were observed among the three groups. However, the infarct ratio was significantly lower in the ropivacaine group than in the control group (P < 0.05), and the number of necrotic cells in the caudoputamen of the ropivacaine group was significantly lower than in the control group (P < 0.01). Additionally, the number of necrotic and apoptotic cells in theropivacaine group were significantly lower than inthe control group in both the caudoputamen and the frontoparietal cortex (P < 0.05). Conclusions: Brain injury induced by focal cerebral ischemia/reperfusion was reduced by an SCG block using local anesthetics. This finding suggests that a cervical sympathetic block could be considered as another treatment option for the treatment of cerebral vascular diseases.

• Biomolecules & Therapeutics
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• v.28 no.2
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• pp.152-162
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• 2020

Cerebral ischemia exhibits a multiplicity of pathophysiological mechanisms. During ischemic stroke, the reactive oxygen species (ROS) concentration rises to a peak during reperfusion, possibly underlying neuronal death. Recombinant human erythropoietin (EPO) supplementation is one method of treating neurodegenerative disease by reducing the generation of ROS. We investigated the therapeutic effect of PEGylated EPO (P-EPO) on ischemic stroke. Mice were administered P-EPO (5,000 U/kg) via intravenous injection, and middle cerebral artery occlusion (MCAO) followed by reperfusion was performed to induce in vivo ischemic stroke. P-EPO ameliorated MCAO-induced neurological deficit and reduced behavioral disorder and the infarct area. Moreover, lipid peroxidation, expression of inflammatory proteins (cyclooxygenase-2 and inducible nitric oxide synthase), and cytokine levels in blood were reduced by the P-EPO treatment. In addition, higher activation of nuclear factor kappa B (NF-κB) was found in the brain after MCAO, but NF-κB activation was reduced in the P-EPO-injected group. Treatment with the NF-κB inhibitor PS-1145 (5 mg/kg) abolished the P-EPO-induced reduction of infarct volume, neuronal death, neuroinflammation, and oxidative stress. Moreover, P-EPO was more effective than EPO (5,000 U/kg) and similar to a tissue plasminogen activator (10 mg/kg). An in vitro study revealed that P-EPO (25, 50, and 100 U/mL) treatment protected against rotenone (100 nM)-induced neuronal loss, neuroinflammation, oxidative stress, and NF-κB activity. These results indicate that the administration of P-EPO exerted neuroprotective effects on cerebral ischemia damage through anti-oxidant and anti-inflammatory properties by inhibiting NF-κB activation.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.488-491
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• 2009

A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.159-162
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• 2008

Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondary to severe carotid stenosis. Stenting was performed for treatment of the right carotid artery stenosis after a one-week cerebral angiogram was completed. Thirty minutes after stent placement, the patient exhibited a generalized seizure. Four hours later, brain MRI revealed left hemispheric cerebral infarction. Complex aorta-like arch elongation, tortuosity, calcification, and acute angulation at the origin of the supra-aortic arteries may increase the risk of procedural complications. In our case, we suggest that difficult carotid artery catheterization, with aggressive maneuvering during stenting, likely injured the tortuous, atherosclerotic aortic arch, and led to infarction of the contralateral cerebral hemisphere by thromboemboli formed on the wall of the atherosclerotic aorta.

• Journal of Korean Neurosurgical Society
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• v.53 no.6
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• pp.368-370
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• 2013

Post-stroke atrial fibrillation has been frequently reported especially in the patients with right insular infarct as an evidence of cerebrogenic mechanism affecting on cardiac rhythm. However, conversion to normal sinus rhythm after stroke in patients who had atrial fibrillation has not been reported. A 88-year-old men who had untreated atrial fibrillation was admitted to hospital due to left middle cerebral artery territory infarction. During admission, second ischemic attack occurred in right middle cerebral artery territory. At that time, his atrial fibrillation converted spontaneously to normal sinus rhythm. Restored sinus rhythm sustained until he died due to sepsis. This case is evidence supporting a theory that brain is associated with control of cardiac rhythm. If no risk factor is revealed by intensive investigation in patients with acute cerebral infarctions that cardioembolism is strongly suspected as a cause, physicians should concern transformation of atrial fibrillation to normal sinus rhythm after stroke.

• The Korea Journal of Herbology
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• v.27 no.6
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• pp.71-76
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• 2012

Objectives : The purpose of this study was to evaluate the neuroprotective effect of Pueraria lobata extract on focal cerebral ischemia in mice. Methods : Focal cerebral ischemia was induced by occlusion of the right middle cerebral artery using the intraluminal filament model. ICR male mice underwent 90 minutes of middle cerebral artery occlusion (MCAo) followed by 24 hours of reperfusion. Mice were administered Pueraria lobata extract orally at the dose of 300mg/kg just prior to reperfusion. Rotarod test and balance beam test were practiced to assess sensory-motor function 23 hours after MCAo. In rotarod test, the latency to fall on the accelerating rotarod was recorded for 5 min. In balance beam test, the score was graded according to number of slips and latency to cross. The infarct volume was measured 24 hours after MCAo using 2% 2,3,5-triphenyltetrazolium chloride (TTC) staining. Results : Pueraria lobata extract treated group showed significant reduction in infarct volume by 27.3% compared to control group (p<0.05). In rotatod test, it also showed significant extension of latency time compared to control group ($67.82{\pm}15.08$ vs. $5.62{\pm}1.06$, p<0.001). In contrast to performance in rotarod test, that in balance beam test did not improve with Pueraria lobata extract treatment. Conclusions : We conclude that Pueraria lobata extract has a significant neuroprotective effect and reduces damage of sensory-motor function in MCAo model. These findings suggest that Pueraria lobata could be a potent neuroprotective agent.