• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.82-87
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• 2007

Objective : Pontine hemorrhages usually result in a much higher morbidity and mortality than any other intracranial vascular lesion. The purpose of this study was to evaluate survival and the contributing factors for patients with pontine hemorrhage. Methods : Of the 41 patients who were admitted to our hospital with their first acute pontine hemorrhage from 1997 to 2005, 35 patients were included in this study. Medical records were reviewed to confirm the accuracy of diagnosis and collect demographic, clinical and radiological data. The patients were divided into two groups, survivors and deceased patients; then the survivors were divided again into a group of patient with good results and those with poor results. The location of the hematoma, maximum anteroposterior [AP] diameter, maximum transverse diameter, hematoma volume, ventricular extension, extension into the midbrain, hydrocephalus and initial Glasgow coma scale [GCS] were evaluated. Results : The two year survival rate was 58.5%. The survival of patients with pontine hemorrhage was affected by initial GCS score and transverse hematoma dimeter. Functional outcome of patients who survived was affected by initial GCS, maximum transverse diameter, maximum AP diameter and hematoma volume. Conclusion : The rate of survival after pontine hemorrhage is associated with the transverse diameter of the hematoma and more importantly the initial GCS. Long-term outcome of survivors is influenced by the initial GCS, transverse diameter, AP diameter and volume. Through the multivariate analysis, initial GCS is the only significant factor on survival. Strictly speaking, initial GCS is not modifiable. However, surgical reduction may be considered to amend theses decisive factors. Additional study for indication, timing and method of surgical management is needed.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.21 no.2
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• pp.110-119
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• 2014

Purpose: The objectives of this study were to identify interventions and to analyze the characteristics of headaches among hospitalized patients with subarachnoid hemorrhage with moderate or severe headaches. Methods: A retrospective review of the electronic medical records of 210 patients who received treatment for subarachnoid hemorrhage was conducted. Data collection was done using a structured headache record sheet. Data analysis was carried out using the PASW 18.0 version program. Results: There were significant differences in number and duration of headaches of headaches according to the presence of vasospasm, increased intracranial pressure, extraventricular drainage, use of hypertonic solution, and hospitalization period (p<0.05). Patients with vasospasm and extraventricular drainage experienced the most severe headache for a duration of 3 to 7 days. Other patients experienced the most severe headache for around 1-2 days. Conclusion: Hospitalized patients with subarachnoid hemorrhage who had vasospasms experienced more headaches and the duration of these headaches were longer. In particular, the assessment and interventions for headaches should increase and be carried out actively during this time because the intensity of these headaches is severe and lasts for 3-7 days. Additionally, we emphasize the need for regular administration of analgesics in order to promote patients' well-being. On the basis of the results of this study,we suggest that evidence-based interventions for the care of headaches among hospitalized patients with subarachnoid hemorrhage should be developed.

• Journal of Korean Neurosurgical Society
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• v.63 no.1
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• pp.56-68
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• 2020

Objective : To analyze the incidence and treatment trends of hemorrhagic stroke (HS), according to HS subtypes, using nationwide data in Korea from January 2008 to December 2016. Methods : We used data from the national health-claim database provided by the National Health Insurance Service for 2008-2016 using the International Classification of Diseases. The crude incidence and age-standardized incidence of each disease associated with HS, which included intracranial aneurysm (IA), hypertensive intracerebral hemorrhage (ICH), and arteriovenous malformation (AVM), were calculated and additional analysis was conducted according to age and sex. Changes in trends in treatment methods and number of treatments were analyzed for each cerebrovascular disease using the Korean Classification of Diseases procedure codes. Results : In 2016, the total number of newly diagnosed adult patients with HS was 24169, showing a decrease by 7.0% since 2008; the age-standardized incidence of HS was 46.2 per 100000 person-years. The age-standardized incidence of unruptured IA (UIA) in adults was 71.4 per 100000 person-years-increased by 2.6-fold since 2008-while that of ruptured IA (RIA) was 12.6 per 100000 person-years, which had decreased at a rate of 20.3% since 2008. The number of coil embolization (CE) for UIA increased by 3.4-fold over 9 years and exceeded that of clipping since 2008. With respect to RIA, CE increased by 2.0-fold over 9 years and exceeded that of clipping from 2014. As for spontaneous ICH in adults, the age-standardized incidence was 31.3 per 100000 person-years in 2016-decreased by 34.7% since 2008-and 14.6% of patients diagnosed with ICH were treated in 2016, which was not significantly different from the proportion of patients treated since 2008. The age-standardized incidence of unruptured AVM (UAVM) was 2.0 per 100000 person-year in 2016, while that of ruptured AVM (RAVM) was 2.4 per 100000 person-years in 2016, showing a decreasing rate of 17.2% from 2008. The total number of treated patients with AVM declined since 2014. Conclusion : In Korea, age-related cerebral vascular diseases, such as RIA, ICH, and RAVM, demonstrated a declining trend in age-standardized incidence; meanwhile, UIA and UAVM demonstrated an increased trend in both crude incidence and age-standardized incidence for 9 years. The increase in the elderly population, management of hypertension, and development of diagnostic and endovascular techniques appear to have influenced this trend.

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1112-1117
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• 2003

Purpose : Recent advances in the methods of treating cancer in young patients have led to both an increased frequency of CNS complications as well as prolonged life expectancy. We intend to analyze the clinical aspects and laboratory findings of patients with CNS complications during and after treatment. Methods : We reviewed the medical records of 174 childhood cancer patients treated with chemotherapy admitted to the Dept. of Pediatrics, Keimyung University Dongsan Hospital, from January 1995 to November 2002. Among them, 15 cases with CNS complications were investigated in this study. Results : CNS abnormalities were found in 13 patients by CT or MRI during treatment such as leukoencephalopathy(n=7), mineralizing microangiopathy(n=4), brain infarction(n=3), intracranial hemorrhage(n=1), and hypoxic ischemic encephalopathy(n=1). It was found that two patients had two or more CNS abnormalities. Two patients who had no imaging abnormalities had convulsions, possibly after the addition of intrathecal methotrexate. The patients with intracranial hemorrhage and brain infarction had rapid and fatal clinical courses. The hypoxic ischemic encephalopathy following electrolyte imbalance completely recovered after correction of electrolyte. Conclusion : The CNS complications that occur during and after chemotherapy influence prognoses significantly, and remain neurologic sequelae. Therefore early diagnosis and prophylaxis for CNS complications and regular physical examination of patients who have recieved cancer therapy are strongly recommended.

• Journal of Veterinary Clinics
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• v.23 no.2
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• pp.96-101
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• 2006

Four dogs with neurologic dysfunction resulted from intracranial hemorrhage by head trauma were referred to Veterinary Medical Teaching Hospital, Chungnam National University. There were no remarkable findings in survey radiography in four cases. CT and MRI scans were diagnostic in these cases. Three dogs underwent CT scanning. On CT images, the lesion was hyperdense and was not enhanced after intravenous contrast administration in dog 1 and dog 2. On CT of dog 4, there was no significant finding. All of four dogs were verified by dorsal, sagittal, and transverse T1-weighted (T1W) and T2-weighted (T2W) images. Appearance of the lesions in dog 1 and dog 2 was isointense (dog 2) or isointense with hyperintense rim (dog 1) on T1W images and hyperintense on T2W images. In dog 3 and dog 4, there were hypointense and hyperintense lesions on T1Wand T2W images respectively. The lesions in four dogs were located in the left intracerebral region, intracerebral and cerebellovestibular region, subdural space, and right cerebral hemisphere, respectively.

• Annals of Clinical Neurophysiology
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• v.17 no.1
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• pp.41-43
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• 2015

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.392-394
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• 2010

Trochlear nerve palsy associated with spontaneous subarachnoid hemorrhage (SAH) is known to be a rare malady. We report here on a patient who suffered with left trochlear nerve palsy following rupture of a right posterior communicating artery aneurysm. A 56-year-woman visited our emergency department with stuporous mental change. Her Hunt-and-Hess grade was 3 and the Fisher grade was 4. Cerebral angiography revealed a ruptured aneurysm of the right posterior communicating artery. The aneurysm was clipped via a right pterional approach on the day of admission. The patient complained of diplopia when she gazed to the left side, and the ophthalmologist found limited left inferolateral side gazing due to left superior oblique muscle palsy on day 3. Elevated intracranial pressure, intraventricular hemorrhage or a dense clot in the basal cisterns might have caused this trochlear nerve palsy.

• Journal of Korean Neurosurgical Society
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• v.51 no.3
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• pp.141-143
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• 2012

The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.

• Investigative Magnetic Resonance Imaging
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• v.20 no.2
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• pp.120-122
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• 2016

Arachnoid cysts (AC) are intraarachnoidal cerebrospinal fluid collections, and account for 1% of all intracranial space-occupying lesions. Intracystic hemorrhage of the AC can occur spontaneously, but this is an extremely rare event. Herein, we present a case of hemorrhagic AC in a nontraumatic patient in the left middle cranial fossa. We also performed relevant literature review on this disease.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.591-596
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• 2017

Objective : Frameless stereotactic aspiration of a hematoma can be the one of the treatment options for spontaneous intracerebral hemorrhage in the basal ganglia. Postoperative hematoma enlargement, however, can be a serious complication of intracranial surgery that frequently results in severe neurological deficit and even death. Therefore, it is important to identify the risk factors of postoperative hematoma growth. Methods : During a 13-year period, 101 patients underwent minimally invasive frameless stereotactic aspiration for basal ganglia hematoma. Patients were classified into two groups according to whether or not they had postoperative hematoma enlargement in a computed tomography scan. Baseline demographic data and several risk factors, such as hypertension, preoperative hematoma growth, antiplatelet medication, presence of concomitant intraventricular hemorrhage (IVH), were analysed via a univariate statistical study. Results : Nine of 101 patients (8.9%) showed hematoma enlargement after frameless stereotactic aspiration. Among the various risk factors, concomitant IVH and antiplatelet medication were found to be significantly associated with postoperative enlargement of hematomas. Conclusion : In conclusion, our study revealed that aspirin use and concomitant IVH are factors associated with hematoma enlargement subsequent to frameless stereotactic aspiration for basal ganglia hematoma.