• Title/Summary/Keyword: cerebral nervous disease

검색결과 47건 처리시간 0.019초

Understanding the importance of cerebrovascular involvement in Kawasaki disease

  • Yeom, Jung Sook;Cho, Jae Young;Woo, Hyang-Ok
    • Clinical and Experimental Pediatrics
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    • 제62권9호
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    • pp.334-339
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    • 2019
  • Kawasaki disease (KD) is a systemic vasculitis in infants and young children. However, its natural history has not been fully elucidated because the first case was reported in the late 1960s and patients who have recovered are just now entering middle age. Nevertheless, much evidence has raised concerns regarding the subclinical vascular changes that occur in post-KD patients. KD research has focused on coronary artery aneurysms because they are directly associated with fatality. However, aneurysms have been reported in other extracardiac muscular arteries and their fate seems to resemble that of coronary artery aneurysms. Arterial strokes in KD cases are rarely reported. Asymptomatic ischemic lesions were observed in a prospective study of brain vascular lesions in KD patients with coronary artery aneurysms. The findings of a study of single-photon emission computed tomography suggested that asymptomatic cerebral vasculitis is more common than we believed. Some authors assumed that the need to consider the possibility of brain vascular lesions in severe cases of KD regardless of presence or absence of neurological symptoms. These findings suggest that KD is related with cerebrovascular lesions in children and young adults. Considering the fatal consequences of cerebral vascular involvement in KD patients, increased attention is required. Here we review our understanding of brain vascular involvement in KD.

Cerebral Aspergillosis with Multiple Enhancing Nodules in the Right Cerebral Hemisphere in the Immune-Competent Patient

  • Lee, Gwang-Jun;Jung, Tae-Young;Choi, Seong-Min;Jung, Min-Young
    • Journal of Korean Neurosurgical Society
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    • 제53권5호
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    • pp.312-315
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    • 2013
  • Aspergillosis in the central nervous system (CNS) is a very rare disease in immune-competent patients. There was a case of a healthy man without a history of immune-compromised disease who had invasive aspergillosis with unusual radiologic findings. A 48-year-old healthy man with diabetes mellitus, presented with complaints of blurred vision that persisted for one month. Brain magnetic resonance imaging (MRI) showed multiple nodular enhancing lesions on the right cerebral hemisphere. The diffusion image appeared in a high-signal intensity in these areas. Cerebrospinal fluid examination did not show any infection signs. An open biopsy was done and intraoperative findings showed grayish inflammatory and necrotic tissue without a definitive mass lesion. The pathologic result was a brain abscess caused by fungal infection, morphologically aspergillus. Antifungal agents (Amphotericin B, Ambisome and Voriconazole) were used for treatment for 3 months. The visual symptoms improved. There was no recurrence or abscess pocket, but the remaining focal enhanced lesions were visible in the right temporal and occipital area at a one year follow-up MRI. This immune-competent patient showed multiple enhancing CNS aspergillosis in the cerebral hemisphere, which had a good outcome with antifungal agents.

조기해어탕(調氣解瘀湯)이 XO/XA에 의해 손상(損傷)된 대뇌피질(大腦皮質) 신경세포(神經細胞)에 미치는 영향(影響) (Effects of Jogihaeatag(調氣解瘀湯) on the Cerebral Cortex Neuron injured by XO/XA)

  • 이용근;강형원;류영수
    • 동의신경정신과학회지
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    • 제10권2호
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    • pp.29-45
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    • 1999
  • As the average life span has been lengthened and the rate of senile population has been raised, chronic degenerative diseases incident to aging have been increased rapidly and become a social problem. With this social background, recently, oxygen radicals(OR) have toxic effects on Central Nervous System and Peripheral Nervous System and cause neuropathy such as Parkinson's Disease, Alzheimer Disease. The purpose of this study is to examine the toxic effects caused by Xanthine Oxidase(XO) and the effects of herbal extracts such as Jokihaeatang(JHT) on the treatment of the toxic effects. For this purpose, experiments with the cultured cell from the cerebrums of new born mice were done. The results of these experiments were as follows. 1. X0, an oxygen radical, decreased the survival rate of the cultured cells on NR assay, MTT assay and amount of neurofilaments and increased the amount of lipid peroxidation. 2. JHT have efficacy of increasing the amount of neurofilaments.

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시츄견의 괴사성 뇌막뇌염 증례 보고 (A Case of Necrotizing Meningoencephalitis in a Shih-Tzu Dog)

  • 정지열;윤영민;김재훈
    • 한국임상수의학회지
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    • 제33권1호
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    • pp.70-73
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    • 2016
  • Necrotizing meningoencephalitis (NME) is a unique idiopathic nonsuppurative inflammatory disease of central nervous system in small-sized breed dogs. A 9-year-old intact male Shih-Tzu dog with anorexia, vomiting, salivation and intermittent seizures was submitted to the Jeju National University for diagnosis. Grossly, there were no obvious lesions in the brain, except dilatation of most blood vessels in meninges. Histopathologically, brain revealed severe multifocal nonsuppurative inflammation in perivascular area of meninges and cerebral cortex. Some areas of cerebral parenchyma were replaced with lots of macrophages contained periodic acid-Schiff positive materials. Many new-formed blood vessels were observed around the necrotic regions using Gomori reticulum stain. Immunohistochemistry and reverse transcription-polymerase chain reaction were negative for toxoplasmosis and canine distemper virus. Based on the gross, histopathologic features and antigen detection methods, this case was diagnosed as NME. Here we reported the NME in relatively uncommon breed, Shih-Tzu dog, than other small breed dogs.

A comprehensive review of the therapeutic and pharmacological effects of ginseng and ginsenosides in central nervous system

  • Kim, Hee Jin;Kim, Pitna;Shin, Chan Young
    • Journal of Ginseng Research
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    • 제37권1호
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    • pp.8-29
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    • 2013
  • Ginseng is one of the most widely used herbal medicines in human. Central nervous system (CNS) diseases are most widely investigated diseases among all others in respect to the ginseng's therapeutic effects. These include Alzheimer's disease, Parkinson's disease, cerebral ischemia, depression, and many other neurological disorders including neurodevelopmental disorders. Not only the various types of diseases but also the diverse array of target pathways or molecules ginseng exerts its effect on. These range, for example, from neuroprotection to the regulation of synaptic plasticity and from regulation of neuroinflammatory processes to the regulation of neurotransmitter release, too many to mention. In general, ginseng and even a single compound of ginsenoside produce its effects on multiple sites of action, which make it an ideal candidate to develop multi-target drugs. This is most important in CNS diseases where multiple of etiological and pathological targets working together to regulate the final pathophysiology of diseases. In this review, we tried to provide comprehensive information on the pharmacological and therapeutic effects of ginseng and ginsenosides on neurodegenerative and other neurological diseases. Side by side comparison of the therapeutic effects in various neurological disorders may widen our understanding of the therapeutic potential of ginseng in CNS diseases and the possibility to develop not only symptomatic drugs but also disease modifying reagents based on ginseng.

흉부질환을 병발한 Von Recklinghausen's disease -2예 보고- (Von Recklinghausen's disease involving the chest -Two cases report-)

  • 김치경;박재길;이홍균
    • Journal of Chest Surgery
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    • 제13권2호
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    • pp.149-153
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    • 1980
  • Von Recklinghausen's disease is a systemic hereditary disorder with varied manifestations in bone, soft tissue, nervous system, and skin, the most common of which is the developement of multiple, small, cutaneous tumors with a characteristic histologic picture. Tumors develop after birth and before puberty in most cases, and they increase in number until old age. Malignant neoplasms that complicate multiple neurofibromatosis include gliomas of the optic nerve, astrocytomaas of the cerebral and cerebellar hemispheres, and sarcomas of peripheral nerves (femoral, tibial and intercostal nerves) and somatic soft tissues. Little attention has been paid to the presence of cystic lung disease in association with neurofibromatosis. Currently, most think of thoracic involvement in neurofibromatosis in terms of posterior mediastinal neuroma, pheochrocytoma, meningocele or, less commonly parenchymal pulmonary neurofibromas. Author have experienced 2 cases of Von Recklinghausen's disease. One case developed a hyge malignant Schwannoma in the parietal pleura of left 4th intercostal space and multiple benign neurofibromas (two in intercostal spacees and one in the neck) , and the other has several episodes of pneumothorax resulting from diffuse cystic lung disease which required closed thoracotomy drainage.

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새로운 ABCD1 유전자의 돌연변이를 가지는 소아 대뇌형 부신백질이영양증 1례 (A Case of Childhood Cerebral Form Adrenoleukodystrophy with Novel Mutation in the ABCD1 Gene)

  • 신영림
    • 대한유전성대사질환학회지
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    • 제12권1호
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    • pp.49-53
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    • 2012
  • X 연관 부신백질이영양증(adrenoleukodystrophy, ALD)은 과산화소체베타산화과정(peroxisomal ${\beta}$-oxidation)의 장애로 매우긴사슬지방산(very long chain fatty acids, VLCFA)이 신경계의 백질과 부신피질 및 고환에 축척된다. 이 질환은 과산화소체막단백질(peroxisomal membrane protein)을 형성하는 Xq28에 위치하는 ATP-binding cassette, subfamily D, member 1 (ABCD1) 유전자 돌연변이에 의해 주로 발생한다. X 연관 ALD는 다양한 임상양상을 보이는데 전형적인 소아대뇌형 부신백질이영양증은 10세 이전의 남아에서 대뇌백질에 빠르게 진행하는 탈수초현상을 보인다. 8세 된 남자 환아로 정상발달과정을 보이던 중 초등학교 입학 후에 집중장애와 산만한 모습으로 인해 주의력결핍과다활동장애로 진단받고 치료를 받았었다. 환아는 내원 8개월 전부터 말이 어눌해 지고 걸을 때 오른 발을 끌며 자주 넘어지는 모습을 보여 내원하였고 오른쪽 상, 하지의 근력이 떨어지는 양상이 관찰되었다. 검사상 부신기능저하증 소견을 보였으며 혈청 지방산 분석검사에서는 C26:0, C42:0/C22:0, C26:0/C22:0가 증가하였다. 뇌 자기공명영상에서는 T2와 FLAIR 강조영상에서 양측의 두정후두부의 백질과 소뇌의 백질에서 대칭적으로 고신호강도를 보였다. 환아는 부신백질이영양증로 진단하였고 ABCD1 유전자 분석 검사에서 새로운 c.983delT (p.Met329CysfsX7) 돌연변이가 확인되었다. X 연관 ALD는 유전자형과 표현형에 연관성이 없으며 다양한 임상양상을 보이기 때문에 환자들마다 임상증상을 잘 관찰해야 하며 향후 유전자 기능을 좀 더 파악하고 임상증상에 영향을 주는 다른 요소에 대한 연구가 필요할 것이라 사료된다.

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Surgical Treatment for Acute, Severe Brain Infarction

  • Park, Je-On;Park, Dong-Hyuk;Kim, Sang-Dae;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • 제42권4호
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    • pp.326-330
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    • 2007
  • Objective : Stroke is the most prevalent disease involving the central nervous system. Since medical modalities are sometimes ineffective for the acute edema following massive infarction, surgical decompression may be an effective option when medical treatments fail. The present study was undertaken to assess the outcome and prognostic factors of decompressive surgery in life threatening acute, severe, brain infarction. Methods : We retrospectively analyzed twenty-six patients (17 males and 9 females; average age, 49.7yrs) who underwent decompressive surgery for severe cerebral or cerebellar infarction from January 2003 to December 2006. 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 : Of the 26 patients, 5 (19.2%) showed good recovery, 5 (19.2%) showed moderate disability, 2 (7.7%) severe disability, 6 (23.1%) persistent experienced vegetative state, and 8 (30.8%) death. In this study, the surgical decompression improved outcome for cerebellar infarction, but decompressive surgery did not show a good result for MCA infarction (30.8% overall mortality vs 100% mortality). The dominant-hemisphere infarcts showed worse prognosis, compared with nondominant-hemisphere infarcts (54.5% vs 70%). Poor prognostic factors were diabetes mellitus, dominant-hemisphere infarcts and low preoperative Glasgow Coma Scale (GCS) score. Conclusion : The patients who exhibit clinical deterioration despite aggressive medical management following severe cerebral infarction should be considered for decompressive surgery. For better outcome, prompt surgical treatment is mandatory. We recommend that patients with severe cerebral infarction should be referred to neurosurgical department primarily in emergency setting or as early as possible for such prompt surgical treatment.

결핵성 뇌수막염에 동반된 뇌성 염분소실증후군(Cerebral salt wasting syndrome) 1예 (A Case of Cerebral Salt Wasting Syndrome Associated with Tuberculous Meningitis)

  • 이자영;이은실;이재형;임은주;김형수;장지선;김현규;김두만;박용범;이재영;모은경
    • Tuberculosis and Respiratory Diseases
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    • 제59권3호
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    • pp.306-310
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    • 2005
  • 저자들은 결핵성 뇌수막염을 가진 31세 남자환자에서 심한 다뇨와 저나트륨혈증, 저혈압, 요중 염분소실이 동반되어 있어 CSWS로 진단하고 항결핵제 투여와 식염수, 염류코르티코이드의 투여 후 임상적 호전을 보인 증례 1예를 경험하였기에 보고하는 바이다.

반부성(反復性) 구토(嘔吐) 및 복통(腹痛), 두통(頭痛)을 동반(同伴)한 소아(小兒) 자율신경발작(自律神經發作) 1예(例) 보고(報告) (A Case Report of Autonomic Seizure with Recurrent Vomiting, Abdominal pain and Headache)

  • 구은정;이재원
    • 대한한의학회지
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    • 제17권2호
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    • pp.394-404
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    • 1996
  • Epilepsy is a chronic cerebral. disease resulting from a variety of factors, which is a syndrome with chief complaint of recurrent seizure caused by abnormal electrical discharge of cerebral nerve cell, while the clinical result showed that epilepsia occurs more frequently in pediatrics. A Child having the chief complaint of recerrent vomiting for 2 months undergone the brain and abdominal C.T, MRI, and gastric endoscopy, when the child was normal. While vomiting gas too serious to administer a medicine, a cyclic vomiting repeated with its discontinuation for 2-3 days after continuation for 10 days. As a result, the child visited the ambulatorium of our hospital and then was hospitalized and treated over two times, when there was a remarkably improvement. There was no any particular complaint for 1 year and 2 months, then, the child complained moderate headache. For thjs reason, we performed again electroencephalography, when there appeared in epilepsia opinion. Since then, we have experienced a case of autonomic nervous seizure which was significantly improved by anticonvulsant, and a therapy by using the phlegm resolvents and central stimulants for treating epilepsy(豁痰醒腦治癎法) as an oriental medicine. Therefore, it is to report both treatment view of oriental medicine and analysis on Oriental and Western medical literatures.

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