• Title/Summary/Keyword: primary pontine hemorrhage

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A Case Report of Acute Primary Pontine Hemorrhage with One-and-a-Half Syndrome, Vertigo, and Paresthesia Treated with Eastern-Western Integrative Medicine (급성 원발성 교뇌 출혈 환자의 하나반증후군, 현기증, 이상감각에 대한 한양방 협진치료 : 증례보고)

  • Se-eun Chun;Ji-eun Lee;Min-gyeol Jeon;Yong-jeen Shin;Sun-ho Shin
    • The Journal of Internal Korean Medicine
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    • v.43 no.6
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    • pp.1289-1300
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    • 2022
  • Background: The purpose of this study was to report the improvement of a patient with one-and-a-half syndrome, vertigo, and paresthesia caused by acute primary pontine hemorrhage (PPH) after a combination treatment of traditional Korean and Western medicine. Case report: A 51-year-old female with one-and-a-half syndrome, vertigo, and paresthesia after PPH was treated with Korean medicine, including herbal medication, acupuncture, and moxibustion, and Western medicine, including medication and rehabilitation therapy during hospitalization. Her progress was evaluated by checking for changes in symptoms with the extraocular muscle (EOM) function test, numeral rating scale (NRS), and follow-up brain computed tomography scans and magnetic resonance imaging (MRI). After 41 days of treatment, the EOM movement was improved, leaving limited abduction of the left eye. The NRS scores for vertigo and paresthesia decreased from 10 to 5 and from 10 to 3, respectively. Improvement was noted in hematoma in MRI, but a new ischemic lesion was also discovered. Conclusion: This case reports the clinical course of one-and-a-half syndrome and suggests that a combined therapy of traditional Korean and Western medicine can be useful for PPH patients with one-and-a-half syndrome, vertigo, and paresthesia. However, studies of larger populations are required.

Leptomeningeal Dissemination of a Low-Grade Brainstem Glioma without Local Recurrence

  • Moon, Jung-Ho;Jung, Tae-Young;Jung, Shin;Jang, Woo-Youl
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.109-112
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    • 2012
  • It is rare for low-grade gliomas to disseminate to the leptomeninges. However, low-grade gliomas with dissemination to the leptomeninges have been occasionally reported in children, and have generally been associated with local recurrence. A 16-year-old boy sought evaluation for diplopia and gait disturbance. A brain magnetic resonance imaging (MRI) revealed pontine mass, which was proved to be fibrillary astrocytoma on biopsy, later. Radiation therapy (5400 cGy) was given and the patient's symptoms were improved. He was followed-up radiologically for brain lesion. Seven months after diagnosis he complained of back pain and gait disturbance. A brain MRI showed a newly-developed lesion at the left cerebellopontine angle without an interval change in the primary lesion. A spinal MRI demonstrated leptomeningeal dissemination of the entire spine. Radiation therapy (3750 cGy) to the spine, and adjuvant chemotherapy with a carboplatin plus vincristine regimen were administered. However, he had a progressive course with tumoral hemorrhage and expired 13 months after diagnosis. We report an unusual case of a low-grade brainstem glioma with spinal dissemination, but without local recurrence, and a progressive course associated with hemorrhage.