• Title/Summary/Keyword: neurological examination

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A Case of Recurrent Dermatofibrosarcoma of the Scalp

  • Jo, Tae-Yeon;Kim, Sang-Dae;Kim, Se-Hoon;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.241-243
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    • 2005
  • We report a case of recurrent dermatofibrosarcoma in a 30-years-old woman who had undergone operations three times during 60 months and had received post-operative radiotherapy. On neurological examination, no neurological deficits were noticed. In brain magnetic resonance image(MRI), there was right parieto-occipital scalp mass with high signal in T2-weighted image, low signal in T1-weighted image with homogeneous enhancement. The removal was done including about 2cm uninvolved margins and pathologic examination of the lesion revealed dermatofibrosarcoma protuberans(DFSP). The prognostic factors of local recurrence may be related to surgical margins for resection; the length from the grossly intact margins, and the microscopically controlled excision in margins.

A Study for Whiplash Injury (편타 손상에 관한 고찰)

  • Kim, Young-Min
    • Journal of Korean Physical Therapy Science
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    • v.3 no.1
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    • pp.895-905
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    • 1996
  • A whiplash injury of cervical spine is typically caused by a special kind of accident. It usually involves a driver of an automobile who experiences a direct impact from behind. There are no external signs of the injury, but shearing forces from the rapid flexion and extension momement result in segmental lesions. The extent of injury to the tissue depends upon the force of impact, the exact position of head at the moment of impact, the awareness of impending injury in order to "prepare" the musculature, and the normalcy of all the tissues of the neck. Diagnosis demend a carefully detailed history and a through musculo-skeletal--neurological examination. Whenever possible, the symptoms claimed must be verified by a carefule neurological examination.

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Lumbar herniated disc: spontaneous regression

  • Altun, Idiris;Yuksel, Kasim Zafer
    • The Korean Journal of Pain
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    • v.30 no.1
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    • pp.44-50
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    • 2017
  • Background: Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods: This retrospective cohort was carried out in the neurosurgery departments of hospitals in KahramanmaraŞ city and 23 patients diagnosed with LDH at the levels of L3-L4, L4-L5 or L5-S1 were enrolled. Results: The average age was $38.4{\pm}8.0$ and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. $Las{\grave{e}}gue$ tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3-L4, L4-L5, and L5-S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was $13.6{\pm}5.4$ months (range: 5-22). Conclusions: It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.

A study on manganese health hazards among experienced welders (용접경력자의 망간에 의한 건강 장해에 관한 연구)

  • Kim, Gyu-Hoi;Lim, Hyun-Sul;Yu, Sun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.644-665
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    • 1998
  • This study was conducted to evaluate the health hazards and to develop early diagnostic methods of the manganism in experienced welders and to know the meaning of signal intensities on the brain Magnetic Resonance images. It was carried out from December 1996 to february 1997 with 277 male welders, the duration of welding was at least 5 years or more. The study was consisted of a questionnaire, physical examination and measurements of blood & urine manganese concentrations. Brain Magnetic Resonance imaging was done on 19 study subjects by random sampling. As the duration of welding increases, the positive rates of clinical symptoms, neurological examinations and blood manganese concentrations were also increased. However, physical examinations and urine manganese concentrations were not statistically significant with the duration of welding. Authors couldn't observe any Parkinsonism-like diseases. There were statistically significant correlations between duration of welding and blood manganese concentration(r=0.16, p<0.01). There were not statistically significant correlations between duration of welding and urine manganese concentrations (r=0.06). There were statistically significant correlations between blood & urine manganese concentration(r=0.34, p<0.01). By viewing brain Magnetic Resonance images, 13 welders(68.4 %) among 19 welders were found to have signal intensities. The positive rates of clinical symptoms, physical examinations, neurological examinations and blood & urine manganese concentrations were not statistically different between those with signal intensities and those without signal intensities. We would like to suggest that some non-specific clinical symptoms and neurological signs are correlated with the duration of welding but any Parkinsonism-like diseases had not been observed with these welders. Next we suggest that the high signal intensities on TlWI of brain Magnetic Resonance images are not the sign of manganese intoxication but the sign of manganese deposition.

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Observational Study of Glossodynia (설통에 대한 관찰연구)

  • Shim, So-Ra;Kim, Min-Kyung;Lee, Ji-Hyun;Lu, Hsu-Yuan;Cho, Seung-Yeon;Park, Seong-Uk;Park, Jung-Mi;Bae, Hyung-Sup;Ko, Chang-Nam
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.476-484
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    • 2012
  • Objectives : The purpose of this study was to report the clinical characteristics of glossodynia patients and effects of traditional Korean treatment on glossodynia and to gather data in order to carry out future study. Methods : We surveyed 40 glossodynia patients visiting the Department of Korean Internal Medicine of Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong and analyzed their glossodynia questionnaires, examination results, and progression of symptoms. Results : In Glossodynia patients the average age was 62.4 years old. Glossodynia was more prevalent in females than males (5.67:1). Red tongue color, white fur, and fissured tongue were observed most often. The average glossodynia duration was 36.1 months and the average glossodynia degree was VAS 5.6. The most commonly appearing symptom was burning sense, and dryness of tongue. In Korean medicine diagnosis, Yin, deficiency, Tae-eum was most commonly diagnosed. In herbal medicine, Gamichungsim-tang was the most frequently prescribed. In laboratory tests, zinc deficiency was the most common result. In heart rate variability (HRV), average SDNN was 34.03 and average LF/HF ratio was 2.11. Of 40 patients, 23 completed treatment and their pain was relieved from average VAS 5.52 to VAS 3.63. Pre-and post-treatment results showed a significant difference. The average duration of treatment was 34.91 days. Conclusions : The results of this study suggest that Korean medical approach and treatment for glossodynia could be effective. Further study should be conducted for more valuable information.

An Epidemiological Study on the Neurological Sequelae of Acute Carbon Monoxide Poisoning (급성일산화탄소중독(急性一酸化炭素中毒)의 신경학적(神經學的) 후유증(後遺症)에 관(關)한 역학적(疫學的) 연구(硏究))

  • Park, Byung-Joo;Cho, Soo-Hun;Ahn, Yoon-Ok;Shin, Young-Soo;Yun, Dork-Ro
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.5-24
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    • 1984
  • There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 to February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% $O_2$ group(38.0%) 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation ana all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.

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Intracranial anaplastic oligodendroglioma concurrent with hydrocephalus and syringomyelia in a Boston terrier dog

  • Park, Chul;Kang, Byeong-Teck;Yoo, Jong-Hyun;Kim, Ha-Jung;Jung, Dong-In;Lim, Chae-Young;Kim, Jae-Hoon;Woo, Eung-Je;Kang, Sang-Chul;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.48 no.1
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    • pp.93-98
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    • 2008
  • A 6-year-old female Boston terrier dog was presented with seizure episode, forelimb paraparesis, excessive panting, and ataxia. On physical and neurological examination, episcleral vessel engorgement, delayed postural reaction, delayed pupillary light reflex (both direct and consensual), and crossed forelimb were noted. Serum biochemical profiles were not remarkable other than mildly elevated hepatic enzymes. On cerebrospinal fluid analysis, elevated protein concentration was observed. In magnetic resonance imaging scans, the left frontal brain lesion with ring enhancement strongly suggested the presence of intracranial tumor. Concurrently, secondary hydrocephalus and syringomyelia were also observed. The dog was euthanized at 4 months after initial presentation because of aggravated neurological signs. This case was definitely diagnosed as an intracranial anaplastic oligodendroglioma based on postmortem histopathologic examination.

Skull Metastasis of Thyroid Carcinoma - Case Report - (원발병소가 갑상선인 전이성 두개골 종양 2례 - 증례보고 -)

  • Kang, Han Sug;Park, Yong Seok;Lee, Young Bae;Lee, Kyu Chun;Mok, Jin Ho;Kim, Han Sik
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1372-1376
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    • 2000
  • The authors present two cases of lytic skull metastasis from thyroid carcinoma. The first case is a 62-year-old female who was diagnosed as thyroid cancer one year ago. She complained a mass over the right parietal area but showed no neurological abnormalities. The mass didn't invade the dura, and was completely removed. Histopathological examination revealed the insular thyroid carcinoma, composed of undifferenciated cells that were responded to thyroglobulin in immunohistochemical staining. The second case is a 75-year-old female who complained a mass over the right parietal and neck area without any neurological abnormality. The mass was confined to the epidural region which was associated with osteolytic change of skull. It was also completely removed. Histopathological examination of mass revealed the follicular thyroid carcinoma.

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An Effective Transcranial Electric Motor-Evoked Potentials Method in Spinal Dural Arteriovenous Fistula Ligation Surgery (척수경막동정맥루 결찰술에서의 효과적인 경두개운동유발전위 검사방법)

  • Jang, Min Hwan;Lee, In Seok;Lim, Sung Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.193-198
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    • 2021
  • The purpose of spinal dural arteriovenous fistula (SDAVF) ligation is to prevent neurological injury and the poor blood supply through ligation of arteriovenous fistula. Therefore, intraoperative neurophysiological monitoring (INM) is required via multimodal neurological examination for minimizing the side effects after surgery based on the patient's symptoms. Transcranial electric motor-evoked potentials (TceMEP) help to check the condition of the corticospinal tract. Whenever ligation is performed, TceMEP should be performed every minute to check for abnormalities. However, an examiner's lack of knowledge about the operation procedure and examination and also poor communication between the examiner and surgeon can cause incorrect timing of the stimulation of TceMEP that interferes with the procedure and causes side effects such as paralysis and motor weakness. As a result of this SDAVF ligation survey, it is believed that for proper INM, case reports will be needed along with further research and the examiner will also have to work closely with the surgeon to minimize neurological damage to patients.

Two Cases of Gami-Guibitang on Cognitive Impairment after Stroke with Improved Recall Memory including Korean Medicine (가미귀비탕을 포함한 한방치료로 회상기억이 향상된 뇌졸중 후 인지저하 환자 2례)

  • Kim, Jeong-Hwa;Lee, Hyeong-min;Shin, Hee-yeon;Kim, Hari;Yang, Seung-Bo;Cho, Seung-Yeon;Park, Seong-Uk;Ko, Chang-Nam;Park, Jung-Mi
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.19 no.1
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    • pp.21-30
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    • 2018
  • ■ Objectives This case study is to report the two cases of Gami-Guibitang on cognitive impairment after stroke with improved recall memory. ■ Methods We used Korean medicine treatments including Gami-guibitang, acupuncture and moxibustion to treat patients who had cognitive impairment after stroke for at least two months. We observed the changes of symptoms by measuring Korean version of Mini-mental status examination (MMSE-K), Clinical Dementia Rating (CDR) and Global Detration Scale (GDS). ■ Results After treatment, the patient's symptoms were improved including MMSE-K, CDR and GDS. Improvement appeared to be prominent in recall memory. The general condition were also improved after treatment. ■ Conclusion This clinical case study suggests that Korean medicine including Gami-guibitang could be used to treat patients who had cognitive impairment after stroke especially suffering from degraded recall memory.

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