• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.138-145
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• 2017

Objectives: The purpose of this case study is to describe the effect of Korean medicine on a patient with delirium caused by a left middle cerebral artery infarct. Methods: The patient was treated with Sopungbosimdodam-tang, acupuncture, and moxibustion. The Korean version of the Delirium Rating Scale (K-DRS), Neelon and Champagne (NEECHAM) Confusion Scale, and Korean Version of the Mini-Mental State Examination (MMSE-K) were used to evaluate the effect of the treatment. Results: After 50 days of treatment with Sopungbosimdodam-tang, the patient's K-DRS score decreased from 16 to 8. The NEECHAM Confusion Scale also improved from 17 to 23, and the MMSE-K score improved from 1 to 7. Conclusion: This clinical study suggested that Korean medicine could contribute greatly to the treatment of delirium caused by a left middle cerebral artery infarct.

• The Journal of Internal Korean Medicine
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• v.21 no.2
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• pp.319-327
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• 2000

To evaluate the effect of Bangpungdangkwi-eum extracts on reperfusion following the middle cerebral artery occulsion in Sprague Dawley rats, the neuron protection effect were investigated through examining the size of cerebral infarction, cerebral edema, and the morphologic change of neuron. The results were obtained as follows; 1. The size of cerabral infarction in sample group is significantly decreased compared with that in control group. Sample group has approximately 17% cerebral infarction parts induced by ischemia in cerebrum while control group has approximately 22%. 2. The volume of cerebral edema in sample group is significantly decreased compared with that in control group. The volumn in sample group is increased by approximately 4.4% compared with that in normal group while that in control group is increased by approximately 7.7%. 3. The optical microscopic examination reveals that the damage of neurons in the ischemic parts and CA1 and CA3 region of hippocampus in the same side of the ischemic parts was the most high and the damage in sample group is decreased compared with that in control group.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.337-341
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• 2007

Objective : Repeated administration of mannitol in the setting of large hemispheric infarction is a controversial and poorly defined therapeutic intervention. This study was performed to examine the effects of multiple-dose mannitol on a brain edema after large hemispheric infarction. Methods : A middle cerebral artery was occluded with the rat suture model for 6 hours and reperfused in 22 rats. The rats were randomly assigned to either control (n=10) or the mannitol-treated group (n=12) in which intravenous mannitol infusions (0.8 g/kg) were performed six times every four hours. After staining a brain slice with 2,3,5-triphenyltetrazolium chloride, the weight of hemispheres, infarcted (IH) and contralateral (CH), and the IH/CH weight ratio were examined, and then hemispheric accumulation of mannitol was photometrically evaluated based on formation of NADH catalyzed by mannitol dehydrogenase. Results : Mannitol administration produced changes in body weight of $-7.6{\pm}1.1%$, increased plasma osmolality to $312{\pm}8\;mOsm/L$. It remarkably increased weight of IH ($0.77{\pm}0.06\;gm$ versus $0.68{\pm}0.03\;gm$ : p<0.01) and the IH/CH weight ratio ($1.23{\pm}0.07$ versus $1.12{\pm}0.05$ : p<0.01). The photometric absorption at 340 nm of the cerebral tissue in the mannitol-treated group was increased to $0.375{\pm}0.071$ and $0.239{\pm}0.051$ in the IH and CH, respectively from $0.167{\pm}0.082$ and $0.162{\pm}0.091$ in the IH and CH of the control group (p<0.01). Conclusion : Multiple-dose mannitol is likely to aggravate cerebral edema due to parenchymal accumulation of mannitol in the infarcted brain tissue.

• 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.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1996.04a
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• pp.215-215
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• 1996

The present study examined chronic effects of transient focal cerebral ischemia on the substantia nigra, a remote exofocal area, using immunohistochenmical and receptor autoradiographic techniques. Transient focal cerebral ischemia was induced by middle cerebral artery (MCA) occlusion for 60 or 90 min followed by reperfusion using silicone-coated 4-0 nylon monofilament in male Wistar rats. After 1- or 2-week reperfusion following transient MCA occlusion, there were partial losses of tyrosine hydroxylase-immunoreactive dopaminergic neurons, incieases in glial fibrillary acidic protein-immunoreactive cells (gliosis), decreases in [$^3$H]YM-09151-2 binding for dopamine D$_2$ receptors, and marked atrophy in the ipsilateral substantia nigra. The precise mechanism(s) of exofocal damage to the substantia nigra is remained to be elucidated.

• Proceedings of the PSK Conference
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• 2002.10a
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• pp.305.1-305.1
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• 2002

The temporal profiles of the changes of dopaminergic cell and microglial activation induced by transient cerebral ischemia was investigated in the substantia nigral region which lay outside ischemic areas of rat brain after middle cerebral artery occlusion (MCAO). Transient cerebral ischemia was induced by intraluminal occlusion of the right middle cerebral artery for 2 hand reperfusion was continued for 1, 2. 3. 7. 10. 14. 30, 60. and 120 days. Activated microglial cells were visualized with immunohistochmistry using OX-43 antibody. (omitted)

• The Journal of Korean Medicine
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• v.23 no.1
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• pp.1-10
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• 2002

Objectives: Uncariae Ramulus Et Uncus extract is clinically used in Korea to treat ischemic cerebral damage. The present study was undertaken to study the neuroprotective effect of Uncariae Ramulus Et Uncus extract in middle cerebral artery occlusion (MCAO) rats. Methods: Changes of extracellular levels of dopamine, DOPAC, HVA. and HIAA in striatum were collected at 20 minutes interval by in vivo microdialysis and then analyzed by HPLC (high performance liquid chromatography) in rats subjected to permanent focal cerebral ischemia induced by 2 hours of MCAO. Uncariae Ramulus Et Uncus extract was orally administrated before MCAO. Different animals were used for measurement of cerebral infarction volume induced by 24 hours of MCAO with TIC staining and image analysis. Results: Extracellular levels of dopamine decreased after treatment with Uncariae Ramulus Et Uncus extract, while extracellular levels of DOPAC and HVA significantly increased. Cerebral infarction volume also significantly decreased after treatment with Uncariae Ramulus Et Uncus extract. Conclusions: These results provided evidence that Uncariae Ramulus Et Uncus extract can produce a neuroprotective effect on cerebral ischemia by regulating extracellular excitatory neurotransmitters.

• Investigative Magnetic Resonance Imaging
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• v.22 no.4
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• pp.266-271
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• 2018

A 66-year-old woman was referred for treatment of incidental detection of two intracranial aneurysms. Time-of-flight MR angiography (TOF MRA) revealed two aneurysms at the M1 segment of the right middle cerebral artery, and clinoid segment of left internal carotid artery, respectively. On digital subtraction angiography, there was a saccular aneurysm on the left internal carotid artery, but the other aneurysm was not detected on the right middle cerebral artery. Based on comprehensive review of imaging findings, organized thrombosed aneurysm was judged as the most likely diagnosis. In the presented report, magnetization transfer (MT) pulse to TOF MRA was used, to differentiate aneurysm-mimicking lesion on TOF MRA. We report that MT technique could be effective in differentiating true aneurysm, from possible T1 high signal artifact on TOF MRA.

• Journal of Korean Neurosurgical Society
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• v.53 no.5
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• pp.293-296
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• 2013

The aneurysm arising from fenestrated proximal anterior cerebral artery (ACA) is considered to be unique. The authors report a case of a 59-year-old woman who presented with a subarachnoid hemorrhage (SAH) secondary to a ruptured aneurysm originating from the fenestrated A1 segment of right ACA. The patient had another unruptured aneurysm which was located at the right middle cerebral artery bifurcation. She was successfully treated with surgical clipping for both aneurysms. From the previously existing literatures, we found 18 more cases (1983-2011) of aneurysms associated with fenestrated A1 segment. All cases represented saccular type of aneurysms, and 79% of the patients had SAH. There were three subtypes of the fenestrated A1 aneurysms depending on the anatomical location, relative to the fenestrated segment. The most common type was the aneurysms located on the proximal end of fenestrated artery (82%). Azygos ACA and hypoplastic A1 were frequently accompanied by the aneurysm (33% and 31%, respectively), and multiple aneurysms were shown in three cases (16%). Considering that fenestrated A1 segment is likely to develop an aneurysm, which has high risk of rupture, early management may benefit patients with aneurysms accompanied by fenestrated proximal ACA.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.1
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• pp.11-21
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• 2009

Objectives : This study was performed to investigate the effects of Semen Persicae(SP) on muscle type change and vascularization effect by measuring expression of Myosin heavy chain (MHC) and Vascular endothelial growth factor (VEGF) protein in the Middle cerebral artery occlusion(MCAo) rats. Methods : The middle cerebral artery was occluded, SP extraction was administrated for 4 days. The effects of SP on muscle type change and vascularization were measured. Results : 1. VEGF protein expressions in the Semen Persicae oral administration group of MCAo group were increased compared to the control group. 2. There were no significant difference between the Semen Persicae oral administration of MCAo group and the control group in MHC isoform (Type I, Type IIa) expression change. Conclusions : The present study demonstrates the effect of Semen Persicae in the vascularizing after ischemia, but has no significant effect in musle type change and the improvement of musle atrophy.