• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.308-312
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• 1998

Mycoplasma pneumoniae infection is usually confined to the respiratory tract but it can cause a variety of extrapulmonary manifestations such as rashes, myalgia, hemolytic anemia, cerebral infarction, transverse myelitis, cerebellar ataxia, Guillain-Barre syndrome and meningoencephalitis. Neurologic complications of Mycoplasma pneumonia have been rarely reported until now. Cerebral infarction as a complication of mycoplasma infection in children has been very rarely reported. In our case, in a young girl with M. pneumoniae infection, a cerebral infarct resulted in persistent and significant neurological dysfunction. We report a 11-year-old girl with cerebral infarction associated with clinical and serologic evidence of Mycoplasma infection.

• 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.58 no.2
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• pp.137-140
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• 2015

The most common neurologic manifestations of polycythemia vera (PV) are cerebral infarction and transient ischemic attacks, while cerebral hemorrhage or intracranial dissection has been rarely associated with PV. Here we report the first case of a 59-year-old patient with intracranial supraclinoid internal carotid artery (ICA) dissection causing cerebral infarction and concomitant subarachnoid hemorrhage due to pseudoaneurysm rupture as clinical onset of PV. This case report discusses the possible mechanism and treatment of this extremely rare condition.

• 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.

• Clinical and Experimental Pediatrics
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• v.59 no.3
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• pp.149-152
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• 2016

We report a case of a 5-year-old girl who developed left hemiparesis and left facial palsy, 6 days after the initiation of fever and respiratory symptoms due to pneumonia. Chest radiography, conducted upon admission, showed pneumonic infiltration and pleural effusion in the left lung field. Brain magnetic resonance imaging showed acute ischemic infarction in the right middle cerebral artery territory. Brain magnetic resonance angiography and transfemoral cerebral angiography revealed complete occlusion of the right middle cerebral artery. Mycoplasma pneumoniae infection was identified by a 4-fold increase in IgG antibodies to M. pneumoniae between acute and convalescent sera by enzyme-linked immunosorbent assay. Fibrinogen and D-dimer levels were elevated, while laboratory exams in order to identify other predisposing factors of pediatric stroke were all negative. This is the first reported pediatric case in English literature of a M. pneumoniae-associated cerebral infarction involving complete occlusion of the right middle cerebral artery.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.674-684
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• 2009

Objectives : In conditions of brain infarction, irreversible axon damage occurs in the central nerve system (CNS), because gliosis becomes a physical and a mechanical barrier to axonal regeneration. Reactive gliosis induced by ischemic injury such as middle cerebral artery occlusion is involved with up-regulation of GFAP and CD81. This study was undertaken to examine the effect of the Gongjin-dan (GJD) on CD81 and GFAP expression and its pathway in the rat brain following middle cerebral artery occlusion (MCAO). Methods : In order to study ischemic injuries on the brain, infarction was induced by MCAO using insertion of a single nylon thread, through the internal carotid artery, into a middle cerebral artery. Cresyl violet staining, cerebral infarction size measurement, immunohistochemistry and microscopic examination were used to detect the expression of CD81 and GFAP and the effect on the infarct size and pyramidal cell death in the brain of the rat with cerebral infarction induced by MCAO. Also, c-Fos and ERK expression were measured to investigate the signaling pathway after GJD administration in MCAO rats. Results : Measuring the size of cerebral infarction induced by MCAO in the rat after injection of GJD showed the size had decreased. GJD administration showed pyramidal cell death protection in the hippocampus in the MCAO rat. GJD administration decreased GF AP expression in the MCAO rat. GJD administration decreased CD81 expression in the MCAO rat. GJD administration induced up-regulation of c-FOS expression compared with MCAO. GJD administration induced down-regulation of ERK expression compared with MCAO. Conclusion : We observed that GJD could suppress the reactive gliosis, which disturbs the axonal regeneration in the brain of a rat with cerebral infarction after MCAO by controlling the expression of CD81 and GFAP. The effect may be modulated by the regulation of c-Fos and ERK. These results suggest that GJD can be a candidate to regenerate CNS injury.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.278-283
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• 2001

Objective : Massive cerebral infarction could be accompanied by severe brain swelling and death secondary to transtentorial herniation. Approximately 10% to 15% of middle cerebral artery infarctions are associated with this phenomenon. However, the effectiveness and timing of decompressive surgery are still controversial. In this study, we present our results on the effect of decompressive craniectomy in life threatening cerebral infarction. Method : We retrospectively analyzed 15 patients who underwent decompressive craniectomy for massive cerebral infarction from January 1997 to April 1999. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : All 15 patients(five men, ten women ; mean age, 52.3 years ; right 11, left 4) were treated with wide craniectomy and duroplasty. The average time interval between onset of symptom and surgical decompression was 2.9 days. Clinical signs of uncal herniation(anisocoria, or fixed and dilated pupils) were presented in 13 of 15 patients. Mean Glasgow coma scale(GCS) was 12.4 points on admission, 8.1 points on preoperative state and 11.8 points postoperatively. Overall outcomes were favorable in 5 cases(Glasgow outcome scale : GOS I, II), unfavorable in 6 cases(Glasgow outcome scale : GOS III, IV) and dead in 4 cases. Conclusion : Early decompressive craniectomy before brain stem compression is considered as an effective lifesaving procedure for massive cerebral infarction unresponsive to aggressive medical therapy.

• Korea Journal of Hospital Management
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• v.14 no.4
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• pp.71-87
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• 2009

This study was conducted to present strategies for efficient use of older people's medical expense and efficient management of hospital beds 삭제by analyzing factors which influenced medical charge of inpatients with stroke and medical charge of each medical treatment. The subjects was 1,070 inpatients with stroke in Academic hospital. The result of this study can be summarized as follows. In the case of cerebral hemorrhage, the rate of female was higher than that of male. In the case of cerebral infarction, the rate of male was higher than that of female. With increase of age, patients with cerebral hemorrhage decreased and patients with cerebral infarction increased. Medical charge for cerebral hemorrhage was 12,600,000 won, while that for cerebral infarction was 572,000 won. The medical charge with surgery was four times of that with non-surgery. The total medical charge for inpatients with stroke was 6,860,000 won. The patient payed 2,240,000 won(32.6%) and National Health Insurance Corporation payed 4,620,000 won(67.3%). Among charges of specific medical treatments, operation and treatment charge was highest(27.7%) in the case of cerebral hemorrhage, while examination charge was highest(32.2%)in the case of cerebral infarction. This study will provide basic information for efficient use of Medical Charge for Inpatients with Stroke.

• The Journal of Internal Korean Medicine
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• v.41 no.1
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• pp.97-110
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• 2020

The purpose of this case study was to report the effectiveness of aphasia in patients with cerebral infarction with hydrocephalus. A patient diagnosed with a middle cerebral artery infarction and hydrocephalus was treated with Gami-cheongeumjowi-tang, acupuncture, and moxibustion. The degree of improvement of symptoms was evaluated using the Korean version of the Frenchay Aphasia Screening Test (K-FAST) and the Mini-Mental State Examination-Korea (MMSE-K). At the time of admission, the K-FAST score was 7 points and the MMSE-K score was 4 points because no words other than 'Yes' could be spoken. At discharge, the K-FAST score was 22 points and the MMSE-K score was 19 points. A particularly noticeable improvement was found in spoken and written comprehension, reading, and repetition. The study findings indicate that Korean medicine treatment can be used to treat the symptoms of patients with aphasia. The periventricular region may be distorted by hydrocephalus, resulting in Broca's aphasia in a cerebral infarction of the middle cerebral artery inferior division.

• The Journal of Korean Medicine
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• v.30 no.6
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• pp.35-43
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• 2009

Objectives: Hwangryunhaedok-tang (HRHDT), a prescription composed of four herbs, has been wi dely used in Oriental Medicine for the treatment of cerebral infarction. However, the mechanisms by which the herbal formula affects on the production of pro- and anti-inflammatory cytokines in cerebral infarction patients remain unknown yet. Methods: The levels of pro- and anti-inflammatory cytokines, including tumor necrosis factor (TNF)-a, interleukin (IL)-1b, and IL-6, IL-10, and TGF-${\beta}1$ were determined in peripheral blood mononuclear cells (PBMCs) from cerebral infarction patients under our experimental conditions. Results: The secretory levels of pro- and anti-inflammatory cytokines, including tumor necrosis factor (TNF)-a, interleukin (IL)-1b, and IL-6, and IL-10 were significantly increased in phytohemagglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMCs) from cerebral infarction patients. However, pretreatment with HRHDT significantly inhibited the secretion of pro- and anti-inflammatory in PBMCs. Also, HRHDT induced a significant increase of transforming growth factor (TGF)-b1 in PBMCs. Conclusions: These data indicate that HRHDT may be beneficial in the suppression of inflammatory processes of cerebral infarct through suppression of TNF-$\alpha$, IL-$1{\beta}$, IL-6, and IL-10 and induction of TGF-${\beta}1$.