• Korean Journal of Oriental Medicine
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• v.7 no.1
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• pp.125-134
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• 2001

Intracerebral hemorrhage (ICH) is associated with a considerable proportion of strokes and head injuries. The mechanism of brain cell injury associated with hemorrhage may be different from that due to pure ischemia. Therefore, it is essential that models of intracerebral hemorrhage be developed and well characterized in animal model. Yukmijihwangwon (YM) has been known to reinforce the vital essence and have antioxidant activities. In this study, the protective effects of YM was investigated against ICH in animal models. Adult rats had 2 microliters saline containing 0.5 and 5 unit bacterial collagenase infused into the right caudate nucleus. It was found out that YM was effective in protecting brain against ICH.

• Journal of Korean Neurosurgical Society
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• v.38 no.4
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• pp.309-311
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• 2005

Intracerebral hemorrhage[ICH] following aneurysmal rupture is found in 34% of the previous literature. However, hypertensive ICH concurrent with subarachnoid hemorrhage[SAH] due to an aneurysm rupture is very unusual with only four cases, to our knowledge, having been previously reported in the literature. We describe a patient who presented with aneurysmal SAH concurrent with hypertensive ICH and review of the literature.

• The Korea Journal of Herbology
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• v.27 no.3
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• pp.83-88
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• 2012

Objects : This study was performed in order to observe the effects of water extract of Dendrobii herba on intracerebral hemorrhage(ICH), Method : ICH was induced by the stereotaxic intrastriatal injection of bacterial collagenase type IV in Sprague-Dawley rats. After the water extracts of Dendrobii herba were administrated orally once a day for 3 days, hematoma volume, percentage of brain edema, expression of iNOS and MPO were observed using immunohistochemistry. Results : Rats fed with water extracts of Dendrobii herba showed reduction of hematoma volume and percentage of brain edema compared with controls. In addition, Infiltration of myeloperoxidase (MPO) expressing neutrophil and expression of inducible nitric oxide synthatase(iNOS) were significantly reduced in rats fed with water extracts of Dendrobii herba. Conclusion : These results demonstrated that water extracts of Dendrobii herba reduced brain damage of intracerebral hemorrhage(ICH) and subsequent ICH-induced cerebral edema, and inhibited neutrophil infiltration.

• Journal of Korean Neurosurgical Society
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• v.38 no.6
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• pp.425-430
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• 2005

Objective : Recently, the survival rate and prognosis of spontaneous intracerebral hemorrhage[S-ICH] has improved, and their enhanced survival has become associated with a consequent rise in the recurrence of S-ICH. The aim of this study is to improve the prevention of recurrent S-ICH. Methods : Between January 1999 and March 2004, we experienced 48 cases of recurrence. We classified the patients into the two groups; a double ICH group and a triple ICH group. We investigated their brain CTs, MRIs, cerebral angiographies, and medical records, retrospectively. Results : Majority of patients had the intervals at least 12 months, and most of patients underwent conservative treatment. The most common hemorrhage pattern of recurrence was ganglionic-ganglionic [basal ganglia - basal ganglia], and the second attack was contralateral side of the first attack in a large percentage of all patients. Prognosis of patients was worsened in recurrent attack. Nearly all patients had medical history of hypertension, and most patients have taken antihypertensive medication at the arrival of emergency room. Conclusion : In treating hypertension for S-ICH patients, we stress that blood pressure must be thoroughly controlled over a long period of time.

• Journal of Korean Neurosurgical Society
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• v.50 no.5
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• pp.403-408
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• 2011

Objective : Contrary to some clinical belief, there were quite a few studies regarding animal models of intracerebral hemorrhage (ICH) $in$ $vivo$ suggesting that prior use of statins may improve outcome after ICH. This study reports the effect of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG CoA) reductase inhibitor, simvastatin given before experimental ICH. Methods : Fifty-one rats were subjected to collagenase-induced ICH, subdivided in 3 groups according to simvastatin treatment modality, and behavioral tests were done. Hematoma volume, brain water content and hemispheric atrophy were analyzed. Immunohistochemical staining for microglia (OX-42) and endothelial nitric oxide synthase (eNOS) was performed and caspase-3 activity was also measured. Results : Pre-simvastatin therapy decreased inflammatory reaction and perihematomal cell death, but resulted in no significant reduction of brain edema and no eNOS expression in the perihematomal region. Finally, prior use of simvastatin showed less significant improvement of neurological outcome after experimental ICH when compared to post-simvastatin therapy. Conclusion : The present study suggests that statins therapy after ICH improves neurological outcome, but prior use of statins before ICH might provide only histological improvement, providing no significant impact on neurological outcome against ICH.

• Journal of Korean Neurosurgical Society
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• v.41 no.4
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• pp.230-235
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• 2007

Objective : We investigated the incidence of the vascular abnormalities associated with spontaneous intracerebral hemorrhage [ICH] using three-dimensional computed tomographic angiography [3D-CTA]. Methods : We prospectively assessed consecutive 76 patients with spontaneous intracerebral hemorrhage [ICH] who underwent 3D-CTA between June 2003 and May 2005. The patients with a recent history of trauma or mainly subarachnoid hemorrhage were excluded. We investigated relationship between vascular abnormality and ICH location. The findings of 3D-CTA were classified as one of three patterns with ICH; type A [without evidence of vascular abnormality], type B [with no vascular abnormality as the source of hemorrhage, but with incidental vascular abnormality], and type C [presence of a vascular abnormality as the source of hemorrhage]. Results : Sites of ICH were lobar 26, basal ganglia 23, thalamus 17, posterior fossa 6 and dominant intraventricular hemorrhage [IVH] 4. Among 76 patients, sixteen [21.1%] vascular abnormalities were noted excluding 13 cases of stenoocclusive disease. Sixteen cases included 6 cases of cerebral aneurysms [7.9%], 5 moyamoya diseases [6.6%], 4 arteriovenous malformations [5.3%] and 1 dural sinus thrombosis [1.3%]. Lobar ICH [30.8%] had a higher vascular abnormalities than other types, and younger age [<40] group had a higher incidence of vascular abnormalities than old age group. The patterns of 3D-CTA include sixty cases [79.0%] of type A, 6 cases [7.8%] of type Band 10 cases [13.2%] of type C. The vascular abnormalities were found in 8 [13.5%] of 59 hypertensive patients and 8 [47.0%] of 17 non-hypertensive patients [p=0.006]. Conclusion : 3D-CT angiography is considered a useful screening tool for ICH patients with suspected cerebrovascular abnormalities and should be considered in such clinical settings, especially in lobar type and in non-hypertensive younger patients.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.164-174
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• 2013

Objective : The aim of this study was to determine 30-day mortality and 6-month functional recovery rates in spontaneous intracerebral hemorrhage (S-ICH) patients undergoing hemodialysis treatment for end-stage renal disease (ESRD), and to compare the outcomes of these patients and S-ICH patients without ESRD. Methods : The medical records of 1943 S-ICH patients from January 2000 to December 2011 were retrospectively analyzed with focus on demographic, radiological, and laboratory characteristics. Results : A total of 1558 supratentorial S-ICH patients were included in the present study and 102 (6.5%) were ESRD patients. The 30-day mortality of the S-ICH patients with ESRD was 53.9%, and 29.4% achieved good functional recovery at 6 months post-S-ICH. Multivariate analysis showed that age, Glasgow Coma Scale (GCS) score, pupillary abnormality, ventricular extension of hemorrhage, hemorrhagic volume, hematoma enlargement, anemia, and treatment modality were independently associated with 30-day mortality in S-ICH patients with ESRD (p<0.05), and that GCS score, volume of hemorrhage, conservative treatment, and shorter hemodialysis duration was independently associated with good functional recovery at 6 months post-S-ICH in patients with ESRD (p<0.05). Conclusion : This retrospective study showed worse outcome after S-ICH in patients with ESRD than those without ESRD; 30-day mortality was four times higher and the functional recovery rate was significantly lower in S-ICH patients with ESRD than in S-ICH patients without ESRD.

• Journal of Korean Neurosurgical Society
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• v.56 no.4
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• pp.303-309
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• 2014

Objective : The purpose of this study was to retrospectively review cases of intracerebral hemorrhage (ICH) medically treated at our institution to determine if the CT angiography (CTA) 'spot sign' predicts in-hospital mortality and clinical outcome at 3 months in patients with spontaneous ICH. Methods : We conducted a retrospective review of all consecutive patients who were admitted to the department of neurosurgery. Clinical data of patients with ICH were collected by 2 neurosurgeons blinded to the radiological data and at the 90-day follow-up. Results : Multivariate logistic regression analysis identified predictors of poor outcome; we found that hematoma location, spot sign, and intraventricular hemorrhage were independent predictors of poor outcome. In-hospital mortality was 57.4% (35 of 61) in the CTA spot-sign positive group versus 7.9% (10 of 126) in the CTA spot-sign negative group. In multivariate logistic analysis, we found that presence of spot sign and presence of volume expansion were independent predictors for the in-hospital mortality of ICH. Conclusion : The spot sign is a strong independent predictor of hematoma expansion, mortality, and poor clinical outcome in primary ICH. In this study, we emphasized the importance of hematoma expansion as a therapeutic target in both clinical practice and research.

• Korean Journal of Exercise Nutrition
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• v.13 no.2
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• pp.115-122
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• 2009

Intracerebral hemorrhage (ICH) is a common cause of stroke, and it occurs mainly in the striatum, thalamus, cerebellum, and pons. Physical exercise is known to ameliorate neurologic impairment induced by various brain insults. In the present study, the influence of pre-and post-conditioning of treadmill exercise on spatial learning ability, the lesion volume, and apoptotic neuronal cell death in the striatum following ICH in rats was investigated. ICH in the striatum was induced by injection of collagenase using strereotaxic instrument. The rats in the pre-exercise group were scheduled to run on a treadmill before ICH induction for 2 consecutive weeks. The rats in the post-exercise group were scheduled to run on a treadmill after ICH induction for 2 weeks. The rats in the pre-exercise and post-exercise group were scheduled to run on a preconditioning treadmill exercise 2 weeks before ICH induction until postconditioning treadmill exercise 2 weeks after ICH induction, except the day of surgery. For this study, radial arm maze task, Nissl staining, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, and immunohistochemistry for caspase-3 were performed. Our date showed that treadmill exercise suppressed the ICH-induced apoptotic neuronal cell death and decreased lesion volume in the stratum. Treadmill exercise also alleviated the ICH-induced impairment of spatial learning ability. Preconditioning treadmill exercise before the ICH insult and postconditioning treadmill exercise after the ICH insult showed similar effectiveness on the recovery of ICH. In this study, however, preconditioning exercise before the ICH insult and postconditioning exercise after the ICH insult showed the most potent effectiveness on the recovery of ICH.

• Journal of Korean Neurosurgical Society
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• v.38 no.6
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• pp.468-470
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• 2005

The recurrent intracerebral hemorrhage[ICH] in hypertensive patients is not an unusual event, but the simultaneous occurrence of multiple ICH is rare. A 70-year-old woman presented with bilateral simultaneous hypertensive intracerebral hemorrhages in both thalami. The complaints of the patient were unconsciousness [semicomatose mental state] and quadriparesis Grade II. The patient was managed conservatively. At discharge, the patient was awake [drowsy mental state], but Grade III according to the Glasgow Outcome Score. This paper reviews the clinical relevance, possible etiology, and treatment of bilateral thalamic ICH.